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
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
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DOI：
10.1136/bmj.317.7156.437
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发表时间：
1998-08-15
影响因子：
105.7
通讯作者：
Vierucci, A
中科院分区：
文献类型：
--
作者：
Resti, M;Azzari, C;Vierucci, A
目的：确定未感染HIV-1的女性中丙型肝炎病毒垂直传播的危险因素和时间。设计：随访中位数为28（范围24-38）个月的婴儿出生的妇女有抗体的丙型肝炎病毒，但没有HIV-1。受试者：442名母亲和婴儿，其中403人完成了研究。主要结果测量：婴儿中存在丙型肝炎病毒抗体和病毒RNA以及丙氨酸氨基转移酶活性。病毒RNA的存在，感染丙型肝炎的方法，分娩的方法，和类型的婴儿喂养mother.Results：13的403名儿童获得丙型肝炎病毒感染在随访结束时。所有这些孩子都是由丙型肝炎病毒RNA阳性的母亲所生; 128名RNA阴性的母亲中没有一人通过感染（差异5%，95%置信区间2%至7%）。6例患儿出生后立即检测到病毒RNA。111名妇女使用了静脉注射药物，20名接受了输血。11感染的儿童出生的这些妇女相比，2至144没有已知的危险因素（差异7%，2%至12%）。结论：这项研究表明，在未感染艾滋病毒的妇女只有那些丙型肝炎病毒RNA感染的婴儿的风险。传播似乎确实发生在子宫内，输血或静脉注射药物的妇女的传播率高于没有已知感染风险因素的妇女。
Objective: To determine the risk factors for and timing of vertical transmission of hepatitis C virus in women who are not infected with HIV-1.Design: Follow up for a median of 28 (range 24-38) months of babies born to women with antibodies to hepatitis C virus but not HIV-1.Subjects: 442 mothers and babies, of whom 403 completed the study.Main outcome measures: Presence of antibodies to hepatitis C virus and viral RNA and alanine aminotransferase activity in babies. Presence of viral RNA, method of infection with hepatitis C, method of delivery, and type of infant feeding in mothers.Results: 13 of the 403 children had acquired hepatitis C virus infection at the end of follow up. All these children were born to women positive for hepatitis C virus RNA; none of the 128 RNA negative mothers passed on the infection (difference 5%, 95% confidence interval 2% to 7%). 6 children had viral RNA immediately after birth. 111 women had used intravenous drugs and 20 had received blood transfusions. 11 of the infected children were born to these women compared with 2 to the 144 with no known risk factor (difference 7%, 2% to 12%).Conclusions: This study suggests that in women not infected with HIV only those with hepatitis C virus RNA are at risk of infecting their babies. Transmission does seem to occur in utero, and the rate of transmission is higher in women who have had blood transfusions or used intravenous drugs than in women with no known risk factor for infection.