Document Detail


Seroprevalence and mother-to-infant transmission of hepatitis C in asymptomatic Egyptian women.
MedLine Citation:
PMID:  9447371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In this study, we sought to determine (1) the prevalence of hepatitis C virus (HCV) RNA, or its antibodies, in a healthy parturient Egyptian population and (2) the risk of mother-to-infant transmission in this population. METHOD: The serum of 499 pregnant Egyptian women was tested for anti-HCV with ELISA-3 and for HCV RNA by polymerase chain reaction (PCR). Neonatal cord blood and infant blood were similarly tested for anti-HCV and HCV RNA. RESULTS: Recombinant immunoblot assay (RIBA) detected anti-HCV in 65/499 (13%) women; of these, 20/65 (31%) were PCR-positive. The total number of babies born was 499. Of the original group, 97 mothers and infants (HCV-negative) were lost to follow up and were excluded. Sixty-five anti-HCV-positive infants were born vaginally to the 65 anti-HCV-positive mothers, of which twenty (31%) corresponding mothers and babies were also positive for HCV RNA. Of these twenty babies, three died of hepatocellular disease by six months of age; sixteen developed chronic liver disease; the remaining nine remained asymptomatic but were serologically and PCR-positive. The mother-to-infant transmission rate was significantly increased (5%; P < 0.0001). Of the seropositive children, 45/65 (69%; P < 0.0001) seroreverted by eighteen months of age. CONCLUSION: There is a high prevalence of anti-HCV in healthy pregnant Egyptian women and vertical transmission is a major risk for chronic HCV carriers.
Hepatitis C virus (HCV) seropositivity among Egyptian women has been estimated at 13-22%. This study investigated the magnitude of risk of vertical HCV transmission in 499 consecutive, apparently healthy Egyptian women attending antenatal clinics at United Arab Emirates university teaching hospitals in 1994-96. 65 maternal serum samples (13%) were positive for HCV by confirmatory recombinant immunoblot assay and the infants of all these women were anti-HCV positive. HCV RNA was detected by polymerase chain reaction in 20 (31%) of these maternal-infant pairs. Of the 20 infants who were HCV RNA-positive at birth, 4 died of hepatocellular disease before 18 months of age and the remaining 16 developed chronic liver disease. 45 (69%) of the 65 infants seropositive at birth seroconverted over the course of the 18-month follow-up period (mean age of seroconversion, 15 months). These findings indicate that high levels of HCV viremia, like enhanced levels of HIV viremia, facilitate maternal-infant virus transmission. The presence of HCV RNA in the cord blood of the 3 infants who died in the first 3 months of life suggests transplacental pathogenesis in a small proportion of cases. Acquisition at delivery remains the predominant mode of HCV transmission, however, and can be reduced by appropriate screening and counseling of pregnant seropositive chronic carriers of disease.
Authors:
R M Kumar; P M Frossad; P F Hughes
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  75     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-02-26     Completed Date:  1998-02-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  IM; J    
Affiliation:
Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
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MeSH Terms
Descriptor/Qualifier:
Alanine Transaminase / blood
Antibodies, Viral / blood*
Breast Feeding
Egypt
Enzyme-Linked Immunosorbent Assay
Female
Fetal Blood / virology
Hepacivirus / genetics,  immunology*
Hepatitis C / epidemiology,  transmission*,  virology
Humans
Infectious Disease Transmission, Vertical*
Polymerase Chain Reaction
Pregnancy
Pregnancy Complications, Infectious / virology*
RNA, Viral / blood
Risk Factors
Chemical
Reg. No./Substance:
0/Antibodies, Viral; 0/RNA, Viral; EC 2.6.1.2/Alanine Transaminase

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