Alanine transaminase levels in the year before pregnancy predict the risk of hepatitis C virus vertical transmission.
Vertical transmission is the most common route of hepatitis C virus (HCV) infection in children. Transmission risk factors have been described, but most risk factors can only be evaluated using expensive laboratory exams. The aim of the present study was to evaluate whether maternal alanine transaminase (ALT) levels before pregnancy correlate with HCV vertical transmission. Seventy-four transmitting and 403 nontransmitting mothers were evaluated. All mothers enrolled had two ALT determinations in the last year before pregnancy, at least 6 months apart. Mothers were divided into two groups: mothers with persistently normal serum ALT levels and mothers with abnormal ALT levels. In the second group both mothers with constantly raised or with fluctuating ALT levels (one normal and one raised determination) were included. ALT was defined as raised if higher than twice the upper limit of normal. Abnormal ALT levels were found in 39/74 (52.7%) HCV transmitting mothers and in 146/403 (32.6%) nontransmitting mothers (P = 0.008; relative risk 1.96; 95% confidence limits 1.19-3.23). The risk of transmission from mothers with constantly raised ALT levels was more evident than that from mothers with fluctuating ALT levels. Increased ALT levels may reflect a more severe liver disease and a higher viral load, factors known to be associated with vertical transmission. ALT determination, a simple, widely available and inexpensive test, may help in identifying mothers with an increased risk of HCV vertical transmission.
Indolfi
Giuseppe
G
Department of Pediatrics, University of Florence, Anna Meyer Children's Hospital, Florence, Italy.
Azzari
Chiara
C
Moriondo
Maria
M
Lippi
Francesca
F
de Martino
Maurizio
M
Resti
Massimo
M
D000410:Alanine Transaminase / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D035922:Hepatitis A Antibodies / Q000097:blood; D006526:Hepatitis C / Q000150:complications / Q000201:enzymology* / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000201:enzymology*; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D013997:Time Factors
D035922:Hepatitis A Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase