PROSPECTIVE-STUDY OF MOTHER-TO-INFANT TRANSMISSION OF HEPATITIS-C VIRUS (HCV) INFECTION

Seventy-five women with anti-hepatitis C virus (HCV) antibody were enr olled prospectively during pregnancy or at delivery for study of mothe r-to-child transmission of HCV. Twenty-three women were coinfected wit h the human immunodeficiency virus (HIV). Seventy babies were monitore d for at least 6 months. HCV infection was diagnosed in six infants (8 .6%), four of whom were born to anti-HIV-positive mothers. HCV RNA was first detected between 2 and 6 months, and the genotypes of infected babies matched those of their mothers (type 1: n = 4; type 3: n = 2). Identical master sequences of the hypervariable region (HVR1) were det ected in a mother-infant pair. In three babies coinfected with HCV and HIV, anti-HCV disappeared between 2 and 7 months, being persistently negative in two cases monitored for 11 and 26 months. Transmitting mot hers did not differ significantly from those who did not transmit the infection with anti-HIV, HCV genotypes, and viral load at delivery, bu t had lower rate of reactivity to C100 by the recombinant immunoblot a ssay (RIBA) (P < .01). This prospective study confirms transmission of HCV from anti-HIV-negative mothers (4.4% in this series). Absence of anti-C100 antibodies at delivery is apparently related to increased ri sk of vertical transmission. Seronegative HCV infection can be observe d in children coinfected with HIV. (C) 1998 Wiley-Liss, Inc.