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[Transmission of hepatitis C virus from mother to infant]
1Département de Bactériologie-Virologie, CHU Dupuytren, Limoges, France.
The transmission of hepatitis C virus (VHC) by percutaneous exposure to blood contamination is well documented but account for only 50 to 60% of hepatitis C cases. The transmission route for sporadic cases remains controversial and transmission by sexual contact and vertical transmission have been implicated. Antibodies to HCV are detected in 0 to 4.3% of pregnant women varying across geographic regions or origins. Passively transmitted maternal anti-HCV are detected in most of the new-born babies and persist during 6 to 18 months. The estimated risk of vertical transmission varies widely in the literature probably because of methodological considerations. But the detection of HCV-RNA in the blood of children has confirmed vertical transmission of HCV from mother to infant in mothers coinfected or not with human immunodeficiency virus type 1. In case of vertical transmission, some children develop an acute hepatitis or a chronic carrier state with or without chronic liver disease. In this case, the course of HCV RNA and transaminases might reflect the fluctuating viral replication. Some other children, infected at birth, seem to clear the HCV virus. The babies' HCV-antibodies are detected in some infected children but not in all. The follow up of HCV-seropositive pregnant women and their offsprings with more reliable methods should clarify the clinical importance, the rate of transmission and the factors which influence it.
The transmission of hepatitis C virus (VHC) by percutaneous exposure to blood contamination is well documented but account for only 50 to 60% of hepatitis C cases. The transmission route for sporadic cases remains controversial and transmission by sexual contact and vertical transmission have been implicated. Antibodies to HCV are detected in 0 to 4.3% of pregnant women varying across geographic regions or origins. Passively transmitted maternal anti-HCV are detected in most of the new-born babies and persist during 6 to 18 months. The estimated risk of vertical transmission varies widely in the literature probably because of methodological considerations. But the detection of HCV-RNA in the blood of children has confirmed vertical transmission of HCV from mother to infant in mothers coinfected or not with human immunodeficiency virus type 1. In case of vertical transmission, some children develop an acute hepatitis or a chronic carrier state with or without chronic liver disease. In this case, the course of HCV RNA and transaminases might reflect the fluctuating viral replication. Some other children, infected at birth, seem to clear the HCV virus. The babies' HCV-antibodies are detected in some infected children but not in all. The follow up of HCV-seropositive pregnant women and their offsprings with more reliable methods should clarify the clinical importance, the rate of transmission and the factors which influence it.