title: [Anti-HCV testing as a basic standard of monitoring HCV mother-to-child infection: advantages and disadvantages of the method].
abstract: Vertical transmission is an important route of HCV infection. Infants are considered to be infected if two or more HCV-RNA results are positive and/or anti-HCV+ over 18 mo of age. HCV-RNA RT-PCR testing requires high quality certificated centers. Anti-HCV ELISA commercial tests are cheaper and may be performed in all laboratories.
  
  
  OBJECTIVE
  To estimate sufficiency of anti-HCV testing over 18 mo in the diagnostic process of HCV mother-to-child infection.
  
  
  METHODS
  317 children born to HCV infected mothers were observed for 2-4 years. HCV-RNA was determined first at the age of 2-5 mo and subsequent in 6 months intervals, anti-HCV every 3-6 months.
  
  
  RESULTS
  HCV infection (HCV-RNA twice presence) was recognized in 26/317 (8.2%). Anti-HCV+ were found in: 288 (91%) children in 3-6 mo of age, 213 (67.2%) in 7-9 mo, 21 (6.6%) above 18 mo. HCV-RNA was negative during all observation in the group with anti-HCV results group in all determinations in the first year of life. Among 21 children anti-HCV+ over 18 mo there were: 18 with chronic infection (HCV-RNA+, anti-HCV+), 3 achieved HCV-RNA clearance (2 became anti-HCV-, 1 anti-HCV+ during following observation). Among 296 children anti-HCV over 18 mo there were 5 children HCV-RNA+ twice in the first year of life, but all became HCV-RNA- during follow up. In 4 of them (4/296, 1.3%) in spite of anti-HCV- we transiently found HCV-RNA+ above 18 mo of age.
  
  
  CONCLUSIONS
  Anti-HCV presence in children born to HCV infected mothers: a) up to 18 mo of age do not confirm HCV infection. b) over 18 mo of age are indicative of HCV infection, but not always with active HCV replication. Negative results of anti-HCV above 18 mo of age usually allow us to exclude HCV replication, but in 1.3% we found HCV-RNA in anti-HCV- children. Anti-HCV testing over 18 mo of age as only diagnostic procedure may be not enough. Missing HCV replication in the first period of life prevents HCV microreplication follow up.
authors.affiliation: Klinika Chorób Zakaźnych Wieku Dzieciecego Warszawskiego Uniwersytetu Medycznego, Oddział XI, Wojewódzki Szpital Zakaźny w Warszawie. malgorzata.aniszewska@wum.edu.pl
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Aniszewska
authors.forename: Barbara
authors.initials: B
authors.lastname: Kowalik-Mikołajewska
authors.forename: Maria
authors.initials: M
authors.lastname: Pokorska-Spiewak
authors.forename: Magdalena
authors.initials: M
authors.lastname: Marczyńska
mesh_terms: D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000175:diagnosis* / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011044:Poland; D012367:RNA, Viral / Q000097:blood*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012698:Serologic Tests; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral