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PEDIATRICS Vol. 102 No. 2 August 1998, pp. 355-359

Received Dec 10, 1997; accepted Mar 3, 1998.

Monica O. Granovsky*, Howard L. Minkoff, Beatriz H. Tess*, David

Waters§, Angelos Hatzakis, David E. Devoid¶, Sheldon H. Landesman,

Arye Rubinstein#, Adrian M. Di Bisceglie**, and James J. Goedert**

From the * Division of Cancer Epidemiology and Genetics, Viral Epidemiology Branch, National Cancer Institute, National

Institutes of Health, Bethesda, Maryland; the Departments of Obstetrics and Gynecology and Medicine, State University of New York Health Science Center at Brooklyn, Brooklyn, New York; the § Science Application International Corporation, Frederick Cancer Research Center, Frederick, Maryland; the Department of Hygiene and Epidemiology, Athens University and Medical School, Athens, Greece; the Department of Pediatrics, Walter Reed Army Medical Center, Washington, District of Columbia; the # Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York; and the

** Department of Medicine, St Louis University School of Medicine, St Louis, Missouri.

Objectives. To estimate the hepatitis C virus (Hepatitis C Virus) vertical transmission rate, the effect of potential risk factors, and the pattern of Hepatitis C Virus antibody response and viremia in Hepatitis C Virus-infected infants.

Study Design. The Mothers and Infants Cohort Study enrolled both human immunodeficiency virus (HIV)-seropositive and HIV-seronegative pregnant women at five obstetric clinics in New York City in a prospective cohort study between January 1986 and January 1991. Hepatitis C Virus-infected mothers and their 122 offspring were followed-up for a minimum of 12 months for evidence of Hepatitis C Virus infection as determined by persistent Hepatitis C Virus antibodies or detection of Hepatitis C Virus RNA by reverse transcription polymerase chain reaction. Comparisons among groups for categorical variables were performed using the Fisher's exact test.

Results. Seven (6%; 95% confidence interval, 2%-11%) of the 122 infants were Hepatitis C Virus-infected. There was a tendency for increased risk of transmission with maternal viral and obstetrical factors, such as coinfection with HIV (7% vs 4%), high HIV viral load (13% vs 6%), Hepatitis C Virus viremia (8% vs 3%), vaginal delivery (6% vs 0%), and female gender of offspring (8% vs 3%), although none of the associations reached statistical significance. After loss of maternal antibody, Hepatitis C Virus antibody seroconversion occurred at a mean age of 26 months in 3 HIV-coinfected infants compared with 7 months of age in 4 Hepatitis C Virus-infected HIV-uninfected infants. Serial samples showed that Hepatitis C Virus RNA persisted in 6 infants for at least 18 to 54 months.

Conclusions. Our study is in accordance with other studies that have shown low overall Hepatitis C Virus vertical transmission risk and a trend toward higher risk with maternal risk factors such as HIV-coinfection or Hepatitis C Virus viremia. A delay in infant Hepatitis C Virus antibody response may be associated with HIV coinfection although larger studies are needed to confirm these findings.

Key words: hepatitis C virus, human immunodeficiency virus, vertical transmission, children.

This article has been cited by other articles:

Hadzic, N (2001). Hepatitis C in pregnancy. Arch. Dis. Child. Fetal Neonatal Ed. 84: 201F-204

Gibb, D M, Neave, P E, Tookey, P A, Ramsay, M, Harris, H, Balogun, K, Goldberg, D, Mieli-Vergani, G, Kelly, D

(2000). Active surveillance of hepatitis C infection in the UK and Ireland. Arch. Dis. Child. 82: 286-291