Skip to main content
PMC home page
Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 2005 Mar;90(2):F156–F160. doi: 10.1136/adc.2004.059436

When does mother to child transmission of hepatitis C virus occur?

J Mok, L Pembrey, P Tovo, M Newell, t for
PMCID: PMC1721862  PMID: 15724041

Abstract

Objective: To investigate when hepatitis C virus (HCV) infection from mother to child occurs, and evaluate possible associated factors.

Design: Prospective cohort study.

Patients: Fifty four HCV infected children tested within three days of birth and their mothers.

Main outcome measures: HCV RNA polymerase chain reaction (PCR) results.

Results: Seventeen of the children (31%, 95% confidence interval 19% to 46%) were positive in the first 3 days of life and could be assumed to have acquired infection in utero. Testing PCR positive was not associated with sex (53% v 49% boys; p = 0.77) or mode of delivery (29% elective caesarean section in both groups; p = 0.98). Children with evidence of intrauterine infection were significantly more likely to be of lower birth weight and infected with genotype 1 (58% v 12%, p = 0.01). Although a higher proportion of infants born to HCV/HIV co-infected women were PCR positive in the first 3 days of life, this difference did not reach statistical significance; excluding infants born to co-infected women did not affect the results. Thirty seven of the children (68%) were negative in the first 3 days of life, 27 of whom were positive when tested again at 3 months, and nine were first PCR positive after 3 months (one child had no further tests).

Conclusions: These results suggest that at least one third and up to a half of infected children acquired infection in utero. Although postpartum transmission cannot be excluded, these data suggest that it is rare. The role of HCV genotypes in the timing and mechanism of infection should be explored further.

Full Text

The Full Text of this article is available as a PDF (78.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bryson Y. J., Luzuriaga K., Sullivan J. L., Wara D. W. Proposed definitions for in utero versus intrapartum transmission of HIV-1. N Engl J Med. 1992 Oct 22;327(17):1246–1247. doi: 10.1056/NEJM199210223271718. [DOI] [PubMed] [Google Scholar]
  2. Dal Molin Gianna, D'Agaro Pierlanfranco, Ansaldi Filippo, Ciana Giovanni, Fertz Cristina, Alberico Salvatore, Campello Cesare. Mother-to-infant transmission of hepatitis C virus: rate of infection and assessment of viral load and IgM anti-HCV as risk factors. J Med Virol. 2002 Jun;67(2):137–142. doi: 10.1002/jmv.2202. [DOI] [PubMed] [Google Scholar]
  3. Dunn D. T., Brandt C. D., Krivine A., Cassol S. A., Roques P., Borkowsky W., De Rossi A., Denamur E., Ehrnst A., Loveday C. The sensitivity of HIV-1 DNA polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission. AIDS. 1995 Sep;9(9):F7–11. doi: 10.1097/00002030-199509000-00001. [DOI] [PubMed] [Google Scholar]
  4. Dunn D. T., Simonds R. J., Bulterys M., Kalish L. A., Moye J., Jr, de Maria A., Kind C., Rudin C., Denamur E., Krivine A. Interventions to prevent vertical transmission of HIV-1: effect on viral detection rate in early infant samples. AIDS. 2000 Jul 7;14(10):1421–1428. doi: 10.1097/00002030-200007070-00016. [DOI] [PubMed] [Google Scholar]
  5. Giacchino R., Tasso L., Timitilli A., Castagnola E., Cristina E., Sinelli N., Gotta C., Giambartolomei G., Moscatelli P., Picciotto A. Vertical transmission of hepatitis C virus infection: usefulness of viremia detection in HIV-seronegative hepatitis C virus-seropositive mothers. J Pediatr. 1998 Jan;132(1):167–169. doi: 10.1016/s0022-3476(98)70507-4. [DOI] [PubMed] [Google Scholar]
  6. Gibb D. M., Goodall R. L., Dunn D. T., Healy M., Neave P., Cafferkey M., Butler K. Mother-to-child transmission of hepatitis C virus: evidence for preventable peripartum transmission. Lancet. 2000 Sep 9;356(9233):904–907. doi: 10.1016/s0140-6736(00)02681-7. [DOI] [PubMed] [Google Scholar]
  7. Granovsky M. O., Minkoff H. L., Tess B. H., Waters D., Hatzakis A., Devoid D. E., Landesman S. H., Rubinstein A., Di Bisceglie A. M., Goedert J. J. Hepatitis C virus infection in the mothers and infants cohort study. Pediatrics. 1998 Aug;102(2 Pt 1):355–359. doi: 10.1542/peds.102.2.355. [DOI] [PubMed] [Google Scholar]
  8. Kumar R. M., Shahul S. Role of breast-feeding in transmission of hepatitis C virus to infants of HCV-infected mothers. J Hepatol. 1998 Aug;29(2):191–197. doi: 10.1016/s0168-8278(98)80003-2. [DOI] [PubMed] [Google Scholar]
  9. Leroy Valériane, Karon John M., Alioum Ahmadou, Ekpini Ehounou R., van de Perre Philippe, Greenberg Alan E., Msellati Philippe, Hudgens Michael, Dabis François, Wiktor Stefan Z. Postnatal transmission of HIV-1 after a maternal short-course zidovudine peripartum regimen in West Africa. AIDS. 2003 Jul 4;17(10):1493–1501. doi: 10.1097/00002030-200307040-00010. [DOI] [PubMed] [Google Scholar]
  10. Lin H. H., Kao J. H., Hsu H. Y., Ni Y. H., Chang M. H., Huang S. C., Hwang L. H., Chen P. J., Chen D. S. Absence of infection in breast-fed infants born to hepatitis C virus-infected mothers. J Pediatr. 1995 Apr;126(4):589–591. doi: 10.1016/s0022-3476(95)70356-x. [DOI] [PubMed] [Google Scholar]
  11. Pembrey Lucy, Newell Marie-Louise, Tovo Pier-Angelo, van Drimmelen Harry, Quinti Isabella, Furlini Giuliano, Galli Silvia, Meliconi Maria Grazia, Burns Sheila, Hallam Nick. Inter-laboratory comparison of HCV-RNA assay results: implications for multi-centre research. J Med Virol. 2003 Feb;69(2):195–201. doi: 10.1002/jmv.10283. [DOI] [PubMed] [Google Scholar]
  12. Resti M., Azzari C., Mannelli F., Moriondo M., Novembre E., de Martino M., Vierucci A. Mother to child transmission of hepatitis C virus: prospective study of risk factors and timing of infection in children born to women seronegative for HIV-1. Tuscany Study Group on Hepatitis C Virus Infection. BMJ. 1998 Aug 15;317(7156):437–441. doi: 10.1136/bmj.317.7156.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Ruiz-Extremera A., Salmerón J., Torres C., De Rueda P. M., Giménez F., Robles C., Miranda M. T. Follow-up of transmission of hepatitis C to babies of human immunodeficiency virus-negative women: the role of breast-feeding in transmission. Pediatr Infect Dis J. 2000 Jun;19(6):511–516. doi: 10.1097/00006454-200006000-00004. [DOI] [PubMed] [Google Scholar]
  14. Steininger Christoph, Kundi Michael, Jatzko Gerlinde, Kiss Herbert, Lischka Andreas, Holzmann Heidemarie. Increased risk of mother-to-infant transmission of hepatitis C virus by intrapartum infantile exposure to maternal blood. J Infect Dis. 2003 Jan 8;187(3):345–351. doi: 10.1086/367704. [DOI] [PubMed] [Google Scholar]
  15. Thomas D. L., Villano S. A., Riester K. A., Hershow R., Mofenson L. M., Landesman S. H., Hollinger F. B., Davenny K., Riley L., Diaz C. Perinatal transmission of hepatitis C virus from human immunodeficiency virus type 1-infected mothers. Women and Infants Transmission Study. J Infect Dis. 1998 Jun;177(6):1480–1488. doi: 10.1086/515315. [DOI] [PubMed] [Google Scholar]
  16. Thomas S. L., Newell M. L., Peckham C. S., Ades A. E., Hall A. J. A review of hepatitis C virus (HCV) vertical transmission: risks of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection. Int J Epidemiol. 1998 Feb;27(1):108–117. doi: 10.1093/ije/27.1.108. [DOI] [PubMed] [Google Scholar]
  17. Tovo P. A., Palomba E., Ferraris G., Principi N., Ruga E., Dallacasa P., Maccabruni A. Increased risk of maternal-infant hepatitis C virus transmission for women coinfected with human immunodeficiency virus type 1. Italian Study Group for HCV Infection in Children. Clin Infect Dis. 1997 Nov;25(5):1121–1124. doi: 10.1086/516102. [DOI] [PubMed] [Google Scholar]
  18. Weiner A. J., Thaler M. M., Crawford K., Ching K., Kansopon J., Chien D. Y., Hall J. E., Hu F., Houghton M. A unique, predominant hepatitis C virus variant found in an infant born to a mother with multiple variants. J Virol. 1993 Jul;67(7):4365–4368. doi: 10.1128/jvi.67.7.4365-4368.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Zanetti A. R., Tanzi E., Romanò L., Zuin G., Minola E., Vecchi L., Principi N. A prospective study on mother-to-infant transmission of hepatitis C virus. Intervirology. 1998;41(4-5):208–212. doi: 10.1159/000024938. [DOI] [PubMed] [Google Scholar]
  20. Zuccotti G. V., Ribero M. L., Giovannini M., Fasola M., Riva E., Portera G., Biasucci G., Decarlis S., Profeta M. L., Tagger A. Effect of hepatitis C genotype on mother-to-infant transmission of virus. J Pediatr. 1995 Aug;127(2):278–280. doi: 10.1016/s0022-3476(95)70309-8. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood. Fetal and Neonatal Edition are provided here courtesy of BMJ Publishing Group

RESOURCES