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[Evolution of hepatitis C virus (HCV) infection acquired at birth]
E. Minola1, F. Berera, O. Fracassetti
1U.O. di Malattie Infettive e "Gruppo di Studio: Trasmissione Verticale di HCV", A.O. Ospedali Riuniti, Bergamo, Italy.
Insights
Hepatitis C virus (HCV) infection is typically asymptomatic in infants born to infected mothers, often developing chronic features. Viral RNA is detectable early, with consistent genotypes between mothers and children.
Area of Science:
- Pediatric Infectious Diseases
- Hepatology
- Virology
Background:
- Vertical transmission of Hepatitis C virus (HCV) from mother to child is a significant concern.
- Understanding the natural history of HCV infection in neonates is crucial for early intervention and management.
Purpose of the Study:
- To analyze the clinical and virological evolution of Hepatitis C virus (HCV) infection in infants infected at birth.
- To determine the long-term outcomes of perinatal HCV infection in children.
Main Methods:
- Prospective study of 8 infants born to HCV RNA-positive mothers.
- Regular monitoring included serological tests (anti-HCV antibodies), viral load quantification (HCV RNA by RT-PCR), liver enzyme levels (ALT), and viral genotyping.
- Follow-up assessments were conducted at birth, every 3 months for the first year, and every 6 months thereafter.
Main Results:
- HCV RNA was detected in 100% of infants within the first 3 months of life, persisting throughout the study period.
- Viral genotypes in infants matched those of their mothers.
- Elevated ALT levels, indicative of liver inflammation, were observed in 75% of the infants during follow-up.
Conclusions:
- Perinatal Hepatitis C virus (HCV) infection in children often presents asymptomatically.
- The majority of pediatric HCV infections exhibit chronic characteristics, necessitating long-term monitoring.
- Early detection of viral RNA and consistent genotype matching underscore the transmission route.
Abstract:
Objectives Our aim was to analyze the evolution of HCV infection in children infected at birth. Methods Between September 1994 and December 1998 we analyzed in a prospective study 8 children born of anti-HCV and HCV RNA positive women. Each baby was controlled at birth, every 3 months during the first year of life, and then every 6 months searching for anti-HCV antibodies (ELISA 3, RIBA 2-3), HCV RNA (RT PCR), ALT and viral genotype. Results Viral RNA was detectable in the first 3 months of life in all babies (100%) and remained positive during the follow-up. Viral genotypes were the same for mothers and their children. In 6 babies (75%) ALT remained pathologic during follow-up. Conclusions HCV infection in children usually has an asymptomatic outcome; the infection has chronic features in the majority of cases.