Prospective cohort study of mother-to-infant infection and clearance of hepatitis C in rural Egyptian villages.
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.
Shebl
Fatma M
FM
Department of Epidemiology and Preventive Medicine or Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
El-Kamary
Samer S
SS
Saleh
Doa'a A
DA
Abdel-Hamid
Mohamed
M
Mikhail
Nabiel
N
Allam
Alif
A
El-Arabi
Hanaa
H
Elhenawy
Ibrahim
I
El-Kafrawy
Sherif
S
El-Daly
Mai
M
Selim
Sahar
S
El-Wahab
Ayman Abd
AA
Mostafa
Mohamed
M
Sharaf
Soraya
S
Hashem
Mohamed
M
Heyward
Scott
S
Stine
O Colin
OC
Magder
Laurence S
LS
Stoszek
Sonia
S
Strickland
G Thomas
GT
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
D018937:Hepatitis C Antibodies; D012367:RNA, Viral