[The risk of vertical HCV transmission in children born to HIV infected mothers].
OBJECTIVE
The aim of the study was to evaluate the incidence of mother-to-infant HCV transmission in children born to HIV positive mothers, to qualify the risk factors of the mother-to-child HCV transmission, to settle of conduct diagnostic principles in a child after exposition on HIV and HCV.


METHODS
52 children, born to 52 HIV-infected mothers were studied between June 2001 and September 2005. The full regimen of investigations was executed in 44 children, 7 fell out from the observation, 1 child was below 12th month of life. The course of gestation, mode and duration of delivery were examined. The following laboratory tests were done: alanine aminotrnsferase (ALT) activity, AbHCV assay in 1s and 13th month of life (EIA--third generation) and genetic material HCV (Amplicor HCV assay v. 2.0--Roche). At the same time the diagnostics of HIV vertical infection was made. HCV/HIV coinfections was diagnosed in 43/52 mothers. HCV vertical transmission was diagnosed based on at least twice tested existence of HCV-RNA in serum in the first year of life and/or HCV-Ab presence in a child >12th month of life.


RESULTS
HCV-antibodies in the first month of life were present in 40/52 children (76.9%). HCV-RNA diagnosed by RT-PCR was detected in 7/43 children (16.2%): in 1 child transient viremia was observed, 6 children had chronic HCV infection. Symptoms of hepatitis infection were observed in 5 among 7 children with HCV transmission. HCV vertical transmission appeared in children of mothers with HCV viremia above 10(5) copies/ml. Vaginal delivery lasting over 4 hours after membrane rupture and emergency cesarean section were statistic significant risk of HCV transmission (significant data--chi2(1) = 5.01, p < 0.05). HIV infection was diagnosed in 4 children, there was no case with coinfection HIV/HCV.


CONCLUSIONS
. All children born to HIV positive mothers need diagnostics of HCV vertical infection, the risk of vertical HCV transmission is high (16.2%). The risk factors of HCV vertical transmission included: high level of HCV viremia in the mother (>10(5) copies/ml), prolonged vaginal delivery (>4 hrs after membrane rupture) and emergency cesarean section. Children from vertical HCV exposition should be followed up at least for 24 months.
Dobosz
Sabina
S
Klinika Chorób Zakaźnych Wieku Dzieciecego AM w Warszawie Wojewódzki Szpital Zakaźny. sabinadobosz@wp.pl
D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors
D018937:Hepatitis C Antibodies; D012367:RNA, Viral