Vertical transmission of hepatitis C virus: risk factors and infantile prognosis.
Xiong SK. Okajima Y. Ishikawa K. Watanabe H. Inaba N.
Department of Obstetrics and Gynecology, Dokkyo University School of Medicine, Tochigi, Japan.
OBJECTIVES: To clarify the incidence and risk factors of the vertical transmission of hepatitis C virus (HCV) and to determine the prognosis of the carrier infants. METHODS: At our hospital, 1,941 non-pathological (non-HIV carriers) Japanese pregnant women were screened for anti-HCV antibodies. Sera of the antibody-positive women were examined by the reverse transcription polymerase chain reaction (RT-PCR) method, and the positive women and their infants were followed by testing HCV-related markers. RESULTS: The HCV carrier rate among the pregnant women was 3.5% (68/1,941). Four among the 65 infants (6.2%) who were successfully followed for more than 6 months developed the HCV carrier-state. Of all the risk factors examined, only the elevation (> or = 110 IU/l) of maternal serum alanine aminotransferase (ALT) was found to be significant for HCV vertical transmission. Seventy-five and 50% of the carrier infants manifested chemical hepatitis and seroconverted to an HCV-RNA-negative status, respectively, during the follow-up period. CONCLUSIONS: The frequency of HCV vertical transmission was 6.2%. Half of the carrier infants became seronegative for HCV-RNA. HCV vertical transmission was significantly affected by the maternal serum ALT level prior to delivery.