title: Hepatitis C Virus (HCV) Vertical Transmission in 12-Month-Old Infants Born to HCV-Infected Women and Assessment of Maternal Risk Factors.
abstract: Background.  Hepatitis C virus (HCV) is an underappreciated cause of pediatric liver disease, most frequently acquired by vertical transmission (VT). Current guidelines that include the option of screening infants for HCV RNA at 1-2 months are based on data prior to current real-time polymerase chain reaction (PCR)-based testing. Previous studies have demonstrated VT rates of 4%-15% and an association with high maternal viral load. We evaluated HCV RNA in infants with HCV VT and assessed maternal risk factors in a prospective cohort in Cairo, Egypt. Methods.  Pregnant women were screened for HCV from December 2012 to March 2014. For those with HCV viremia, their infants were tested at 12 months for HCV RNA using real-time PCR. Maternal risk factors assessed for HCV VT association included HCV RNA levels, mode of delivery, and maternal IL28B genotype. Results.  Of 2514 women screened, a total of 54 women were viremic (2.1%) and delivered 56 infants. Of those, 51 infants of 49 women were tested at 12 months of age. Only 7 infants were viremic, with an HCV VT rate of 14.3% (7 of 49). Median HCV RNA in the infants was 2100 IU/mL. None of the maternal risk factors analyzed were associated with transmission. Conclusions.  In Egypt where HCV is highly endemic, we observed an overall 12-month HCV VT rate of 14.3%. Further studies should focus on better identification of pregnant women more likely to vertically transmit HCV and earlier testing of infants to identify those likely to develop chronicity.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics , University of North Carolina at Chapel Hill School of Medicine.
authors.forename: Ravi
authors.initials: R
authors.lastname: Jhaveri
authors.affiliation: Department of Epidemiology and Public Health , University of Maryland , School of Medicine , Baltimore.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hashem
authors.affiliation: Department of Epidemiology and Public Health , University of Maryland , School of Medicine , Baltimore.
authors.forename: Samer S
authors.initials: SS
authors.lastname: El-Kamary
authors.affiliation: Departments of Public Health and Community Medicine.
authors.forename: Doa'a A
authors.initials: DA
authors.lastname: Saleh
authors.affiliation: Chemical and Clinical Pathology.
authors.forename: Sahar A
authors.initials: SA
authors.lastname: Sharaf
authors.affiliation: Chemical and Clinical Pathology.
authors.forename: Fatma
authors.initials: F
authors.lastname: El-Mougy
authors.affiliation: Chemical and Clinical Pathology.
authors.forename: Lobna
authors.initials: L
authors.lastname: Abdelsalam
authors.affiliation: Obstetrics and Gynecology, Faculty of Medicine , Cairo University , Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ehab
authors.affiliation: Obstetrics and Gynecology, Faculty of Medicine , Cairo University , Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: El-Ghazaly
keywords: Egypt; hepatitis C virus; infants; vertical transmission; viral load