title: Hepatitis C virus-specific cell-mediated immune responses in children born to mothers infected with hepatitis C virus.
abstract: OBJECTIVE
  To investigate the association between hepatitis C virus (HCV)-specific cell-mediated immunity (CMI) responses and viral clearance in children born to mothers infected with HCV.
  
  
  METHODS
  A cross-sectional study of children from a mother-infant cohort in Egypt were enrolled to detect CMI responses to recombinant core and nonstructural HCV antigens (nonstructural segments NS3, NS4a/b, and NS5 of the HCV genome) using an interferon-gamma enzyme-linked immunospot assay. Children born to mothers with chronic HCV were enrolled into 3 groups: transiently viremic (n = 5), aviremic (n = 36), and positive control (n = 6), which consisted of 1 child with chronic HCV from this cohort and another 5 children with chronic HCV from a companion study. Children without HCV born to mothers without HCV (n = 27) served as a negative control group. Wilcoxon rank sum test was used to compare the magnitude of CMI responses between groups.
  
  
  RESULTS
  None of the 6 control children who were positive for HCV responded to any HCV antigen, and 4 (80%) of 5 children with transient viremia responded to at least one HCV antigen, compared with 5 (14%) of 36 and 3 (11%) of 27 children in the aviremic and negative control groups, respectively. Children with transient viremia elicited stronger responses than did negative controls (P = .005), positive controls (P = .011), or children without HCV viremia (P = .012), particularly to nonstructural antigens.
  
  
  CONCLUSIONS
  HCV-specific CMI responses were significantly higher in magnitude and frequency among transiently infected children compared with those persistently infected. This suggests CMI responses may be associated with past viral clearance and can identify children at high risk of infection, who can be targeted for health education, screening, and follow-up.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA. selkamar@epi.umaryland.edu
authors.forename: Samer S
authors.initials: SS
authors.lastname: El-Kamary
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hashem
authors.forename: Doaa A
authors.initials: DA
authors.lastname: Saleh
authors.forename: Sayed F
authors.initials: SF
authors.lastname: Abdelwahab
authors.forename: Maha
authors.initials: M
authors.lastname: Sobhy
authors.forename: Fatma M
authors.initials: FM
authors.lastname: Shebl
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Shardell
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Strickland
authors.forename: Mohamed Tarek
authors.initials: MT
authors.lastname: Shata
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D019698:Hepatitis C, Chronic; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology*; D008297:Male; D009035:Mothers; D011446:Prospective Studies