Prospective cohort study of mother-to-infant infection and clearance of hepatitis C in rural Egyptian villages.
Prospective cohort study of mother-to-infant infection and clearance of hepatitis C in rural Egyptian villages.
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DOI：
10.1002/jmv.21480
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发表时间：
2009-06
影响因子：
12.7
通讯作者：
Strickland, G. Thomas
中科院分区：
文献类型：
--
作者：
Sbebl, Fatma M.;El-Kamary, Samer S.;Saleh, Doa'a A.;Abdel-Hamid, Mohamed;Mikhail, Nabiel;Allam, Alif;El-Arabi, Hanaa;Elhenawy, Ibrahim;El-Kafrawy, Sherif;El-Daly, Mai;Selim, Sahar;El-Wahab, Ayman Abd;Mostafa, Mohamed;Sharaf, Soraya;Hashem, Mohamed;Heyward, Scott;Stine, O. Colin;Magder, Laurence S.;Stoszek, Sonia;Strickland, G. Thomas
虽然丙型肝炎病毒（HCV）从受感染的母亲持续传播给婴儿的报告在4- 8%，短暂的HCV围产期感染也发生。这项前瞻性队列研究确定了埃及农村1，863对母婴的围产期HCV感染率以及早期和晚期清除率。这项研究发现，15.7%和10.9%的孕妇分别有HCV抗体（抗HCV）和HCV-RNA。在这些母亲所生的329名婴儿中，33名（10.0%）在出生后2个月内检测出抗-HCV和HCV-RNA阳性-29名（12.5%）母亲HCV-RNA阳性，4名（一过性感染）母亲仅抗-HCV。15例在1年和/或2年时仍为HCV-RNA阳性（持续感染），而18例在1年时清除了病毒和抗体（短暂感染）。在15例持续性病例中，7例在2或3年内清除了感染。在2至6个月和10至12个月时，分别在80%和5%的婴儿中观察到母体获得性抗HCV。4例围产期感染和1例一过性感染的婴儿经病毒序列相似性分析证实为母亲感染。持续性感染婴儿的母亲的病毒血症是短暂性感染婴儿的母亲的155倍。HCV的母婴传播比一般报道的更频繁。然而，感染的早期和晚期清除经常发生，只有15（4.6%）和8（2.4%）的婴儿出生的HCV-RNA阳性母亲在1岁和2-3岁时可检测到HCV-RNA。调查婴儿如何清除感染可能提供有关HCV保护性免疫的重要信息。
Although persistent transmission of hepatitis C virus (HCV) from infected mothers to their infants is reported in 4–8%, transient HCV perinatal infection also occurs. This prospective cohort study determined perinatal HCV infection- and early and late clearance-rates in 1,863 mother-infant pairs in rural Egyptian villages. This study found 15.7% and 10.9% of pregnant women had HCV antibodies (anti-HCV) and HCV-RNA, respectively. Among 329 infants born of these mothers, 33 (10.0%) tested positive for both anti-HCV and HCV-RNA 2 months following birth—29 (12.5%) having HCV-RNA positive mothers and 4 (with transient infections) having mothers with only anti-HCV. Fifteen remained HCV-RNA positive at one and/or 2 years (persistent infections), while 18 cleared both virus and antibody by 1 year (transient infections). Among the 15 persistent cases, 7 cleared their infections by 2 or 3 years. At 2- to 6- and at 10- to 12-month maternally acquired anti-HCV was observed in 80% and 5% of infants, respectively. Four perinatally infected and one transiently infected infant were confirmed to be infected by their mothers by the sequence similarity of their viruses. Viremia was 155-fold greater in mothers of infants with persistent than mothers of infants with transient infections. Maternal-infant transmission of HCV is more frequent than generally reported. However, both early and late clearance of infection frequently occurs and only 15 (4.6%) and 8 (2.4%) infants born of HCV-RNA positive mothers had detectable HCV-RNA at one and 2–3 years of age. Investigating how infants clear infection may provide important information about protective immunity to HCV.
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