Outcome of infants born to hepatitis C infected women

Background Hepatitis C virus (HCV) can be transmitted vertically from mothe r to infant, either late in pregnancy or at delivery. Aims To determine the outcome of infants born to HCV infected women, to cha racterise epidemiology and to design an appropriate infant monitoring sched ule. Methods Three hundred and fourteen infants, born to 296 HCV positive women between 1994 and 1999 were monitored for a median of 18 months (range 1-52) . Results Forty per cent of infants were small for age and 46% had neonatal a bstinence syndrome (NAS). Of 173 infants of defined status, 11 were infecte d (vertical transmission rate [VTR] 6.4%, 95% Cl 2.8-10). Infected infants were diagnosed at a median of three months (range 0.5-10). Liver transamina ses elevation was documented in 8% of uninfected infants. A negative HCV PC R test before one month of age did not exclude infection but all infected p atients had detectable HCV RNA when next tested (range 2-10 months). Conclusions 94% of infants born to HCV antibody positive women are not HIV infected. Liver transaminase elevation in exposed infants is not always ind icative of infection. A minimum monitoring schedule of testing (PCR and ant ibody) at six to eight weeks, six and 18 months allows early diagnosis whil e detecting late seroconversions.