A prospective study on the mother-to-infant transmission of hepatitis C virus and the prognosis of the infected infants.

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Mother-to-infant transmission of hepatitis C virus (HCV) is suspected as one of the most important routes of natural infection of this virus, but its frequency nor factors affecting this infection are not known. Since the carrier status develops even when adults are infected by HCV,which is rare by hepatitis B virus, the retrospective study of the families of HCV carriers cannot elucidate the above mentioned problems. In this research we conducted a prospective follow-up study of the infants born to HCV carrier mothers found by screening or pregnant women.Pregnant women in six different districts of Japan were screened for serum antibody for HCV (second generation, anti-HCV) and if it was positive the serum HCV RNA was examined using polymerase chain reaction. 0.45 to 1.5% (mean 1%) of the pregnant women were positive for anti-HCV,and 71 to 76% of anti-HCV positive women were also positive for serum HCV RNA.Infants born to anti-HCV positive pregnant women were followed after birth with intervals of one to three months for more than one year after birth, examining their sera for anti-HCV,HCV RNA,as well as transaminase levels. Until now 325 infants had been followed for more than six months after birth, and seventeen of them developed chronic HCV carrier status, all of whom were the products of HCV-RNA positive mothers, and none of the infants born to HCV RNA negative mothers showed the sign of HCV infection. The mean percentage of the development of HCV carrier status was 5.4% among the infants born to HCV RNA positive mothers. There were seven other infants who showed transient infection by HCV before six months of age.Close evaluation of various factors regarding mother-to-infant infection disclosed that 1) the mothers of HCV infected infants showed higher serum HCV RNA level, but 2) no difference of infection rate was found between HCV genotypes, 3) between the density gradient status of virus particles in sera, nor 4) between breast-fed and bottle-fed infants.