title: Prospective cohort study of mother-to-infant infection and clearance of hepatitis C in rural Egyptian villages.
abstract: Although persistent transmission of hepatitis C virus (HCV) from infected mothers to their infants is reported in 4-8%, transient HCV perinatal infection also occurs. This prospective cohort study determined perinatal HCV infection- and early and late clearance-rates in 1,863 mother-infant pairs in rural Egyptian villages. This study found 15.7% and 10.9% of pregnant women had HCV antibodies (anti-HCV) and HCV-RNA, respectively. Among 329 infants born of these mothers, 33 (10.0%) tested positive for both anti-HCV and HCV-RNA 2 months following birth-29 (12.5%) having HCV-RNA positive mothers and 4 (with transient infections) having mothers with only anti-HCV. Fifteen remained HCV-RNA positive at one and/or 2 years (persistent infections), while 18 cleared both virus and antibody by 1 year (transient infections). Among the 15 persistent cases, 7 cleared their infections by 2 or 3 years. At 2- to 6- and at 10- to 12-month maternally acquired anti-HCV was observed in 80% and 5% of infants, respectively. Four perinatally infected and one transiently infected infant were confirmed to be infected by their mothers by the sequence similarity of their viruses. Viremia was 155-fold greater in mothers of infants with persistent than mothers of infants with transient infections. Maternal-infant transmission of HCV is more frequent than generally reported. However, both early and late clearance of infection frequently occurs and only 15 (4.6%) and 8 (2.4%) infants born of HCV-RNA positive mothers had detectable HCV-RNA at one and 2-3 years of age. Investigating how infants clear infection may provide important information about protective immunity to HCV.
authors.affiliation: Department of Epidemiology and Preventive Medicine or Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
authors.forename: Fatma M
authors.initials: FM
authors.lastname: Shebl
authors.forename: Samer S
authors.initials: SS
authors.lastname: El-Kamary
authors.forename: Doa'a A
authors.initials: DA
authors.lastname: Saleh
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Hamid
authors.forename: Nabiel
authors.initials: N
authors.lastname: Mikhail
authors.forename: Alif
authors.initials: A
authors.lastname: Allam
authors.forename: Hanaa
authors.initials: H
authors.lastname: El-Arabi
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Elhenawy
authors.forename: Sherif
authors.initials: S
authors.lastname: El-Kafrawy
authors.forename: Mai
authors.initials: M
authors.lastname: El-Daly
authors.forename: Sahar
authors.initials: S
authors.lastname: Selim
authors.forename: Ayman Abd
authors.initials: AA
authors.lastname: El-Wahab
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mostafa
authors.forename: Soraya
authors.initials: S
authors.lastname: Sharaf
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hashem
authors.forename: Scott
authors.initials: S
authors.lastname: Heyward
authors.forename: O Colin
authors.initials: OC
authors.lastname: Stine
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Magder
authors.forename: Sonia
authors.initials: S
authors.lastname: Stoszek
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Strickland
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D004534:Egypt; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / 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 / Q000821:virology*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012424:Rural Population; D017422:Sequence Analysis, DNA; D013997:Time Factors
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral