LACK OF MOTHER-TO-INFANT TRANSMISSION OF HEPATITIS-C VIRUS IN HUMAN-IMMUNODEFICIENCY-VIRUS SERONEGATIVE WOMEN - A PROSPECTIVE-STUDY WITH HEPATITIS-C VIRUS-RNA TESTING

The published risk of mother-to-infant transmission of hepatitis C vir us varies according to the population studied and the tests used. In a prospective study we used the polymerase chain reaction to assess the risk of vertical transmission of hepatitis C virus in an unselected p opulation of women uninfected by human immunodeficiency virus. Hepatit is C virus antibodies were sought with a second-generation enzyme-link ed immunosorbent assay in 2,367 consecutive pregnant women. Forty-one were positive, and 17 consented to serological follow-up of their offs pring (n = 18). A second-generation recombinant immunoblot assay, ALT determination and hepatitis C virus RNA testing were performed on mate rnal sera obtained during pregnancy and sera from the offspring at bir th and thereafter. Five older brothers or sisters were also tested. He patitis C virus RNA sequences in serum were amplified with a modified nested polymerase chain reaction procedure with primers from the highl y conserved 5' noncoding region of the hepatitis C virus genome. All t he neonates were positive for hepatitis C virus antibodies, with enzym e-linked immunosorbent assay titers and recombinant immunoblot assay p atterns similar to those of their mothers. After birth hepatitis C vir us antibodies gradually disappeared within 6 mo. Hepatitis C virus RNA was consistently negative in the 18 children from birth to 24 mo (ran ge = 3 to 24 mo) and in the 5 older children, regardless of the hepati tis C virus polymerase chain reaction status of the mothers (8 of whom were positive). In conclusion, the lack of vertical transmission of h epatitis C virus in this study suggests that unselected and human immu nodeficiency virus-negative women are at low risk of perinatal transmi ssion of hepatitis C virus, even in the presence of active hepatitis C virus replication.