MECHANISMS OF MOTHER-TO-CHILD TRANSMISSION OF HEPATITIS C VIRUS

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OBJECTIVE : Our purpose was to study the intrafamilial transmission of hepatitis C virus (HCV) and the mother-to-child transmission rate of HCV in babies born to HCV carrier mothers.STUDY DESIGN : Anti-HCV antibody (anti-HCV) was tested for 2,528 consecutive pregnant women using an EIA first or second generation kit.Babies born to anti-HCV-positive mothers and their family members had their anti-HCV and HCV RNA checked.These babies were prospectively studied every 3 month till 1 year and thereafter every 6 month.RESULTS : 1.19% of this population were positive for HCV.Eighteen of the 32 anti-HCV-positive pregnant women (56.3%) had HCV RNA.Six of 26 their husbands (23.1%), 4 of 21 of their mothers (19.0%) and 6 of 11 their fathers (54.5%) had anti-HCV,which were much higher prevalence rates than in the general population (p<0.001). Two among 30 samples of cord blood from babies born to these pregnant women (6.7%) had HCV RNA.Among 29 children born to 18 HCV RNA-positive pregnant women, 4 (13.8%) had HCV RNA,but none of 27 children born to 14 HCV RNA-negative pregnant women.CONCLUSIONS : It is suggested that mother-to-child and intrafamilial transmission of HCV exists and that the route appears to be transplacental in 2 out of 4 cases.Mother-to-child transmission, including by the transplacental route, occurs and its rate may be from 5 to 15%.