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Previous Volume 330:744-750 March 17, 1994 Number 11 Next

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ABSTRACT

Background Although there are case reports of vertical transmission of hepatitis C virus (HCV), it remains uncertain to what extent infected mothers transmit this virus to their infants.

Methods We investigated the transmission of HCV from infected mothers to their babies by analyzing HCV RNA in the blood. Three independent studies were performed. First, 7698 parturient women were tested for anti-HCV antibodies; 53 were positive. Their 54 infants (including one set of twins) were followed prospectively for at least six months and tested for HCV infection. Second, the babies of six women with known HCV disease were prospectively studied. Third, the families of three HCV-infected infants were examined retrospectively.

Results Of the 53 antibody-positive mothers, 31 were also positive for serum HCV RNA. Three of the 54 babies born to these mothers (5.6 percent) became positive for HCV RNA during the follow-up period. None of the babies of the 22 women who were antibody-positive but HCV RNA-negative became positive for HCV RNA. In the second study, HCV RNA was detected in one of the six infants of infected mothers. In the third study, HCV RNA was detected in the mothers of the three HCV-infected infants. In each of the seven infected infants we studied, the genomic sequence of HCV was almost identical to that from the mother. These seven mothers had significantly higher titers of HCV RNA than did the mothers of infants with no evidence of infection (mean [±SD], 10^{6.4 ±0.5} vs. 10^{4.4 ±1.5} per milliliter; P<0.001).

Conclusions HCV is vertically transmitted from mother to infant, and the risk of transmission is correlated with the titer of HCV RNA in the mother. .

Source Information

From the Blood Transfusion Service (H. Ohto), Department of Pediatrics (N.U.), and Department of Obstetrics and Gynecology (C.E.), Fukushima Medical College, Fukushima; the Division of Pediatrics, Gifu Kouseiren Gihoku Hospital, Gifu (S.T.); the Department of Pediatrics (Nobuhiko Sasaki, A.M.) and Immunology Division (H. Okamoto), Jichi Medical School, Tochigi; the Department of Pediatrics, Onomichi General Hospital, Hiroshima (Nobutaka Sasaki); the Second Department of Internal Medicine, National Defense Medical College, Saitama (K.H.); Ishiwata Obstetric and Gynecologic Hospital, Ibaragi (C.I.); the Fourth Department of Medicine, Teikyo University School of Medicine, Kanagawa (M.K.); and the Institute of Immunology, Tokyo (S.M.) -- all in Japan. The other members of the study group are as follows: Mineo Kojima, Kojima Clinic, Gifu; Tatsuya Aikawa, Aikawa Internal Hospital, Ibaragi; Kazumi Shimoda, National Defense Medical College, Saitama; Minoru Sakamoto and Yoshihiro Akahane, Yamanashi Medical College, Yamanashi; Hiroshi Yoshizawa, Hiroshima University School of Medicine, Hiroshima; Takeshi Tanaka, Japanese Red Cross Saitama Blood Center, Saitama; Hajime Tokita, Jichi Medical School, Tochigi; and Fumio Tsuda, the Viral Hepatitis Research Foundation of Japan, Tokyo -- all in Japan.

Address reprint requests to Dr. Mishiro at the Institute of Immunology, Bunkyo-ku Koraku 1-1-10, Tokyo 112, Japan.

Full Text of this Article

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Vertical Transmission of Hepatitis C Virus
Simon H. J., Gurakan B., Oran O., Yigit S., Tighe M. K., Miskovitz P., Leon J., Ohto H., Okamoto H., Mishiro S.
Extract | Full Text  
N Engl J Med 1994; 331:399-400, Aug 11, 1994. Correspondence

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