A Significant Sex—but Not Elective Cesarean Section—Effect on Mother-to-Child Transmission of Hepatitis C Virus Infection

BackgroundRisk factors for mother-to-child transmission of hepatitis C virus (HCV) are poorly quantified Methods.We conducted a European multicenter prospective study of HCV-infected pregnant women and their infants. Children with ⩾2 positive HCV RNA polymerase chain reaction test results and/or ant...

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Published in:	The Journal of infectious diseases Vol. 192; no. 11; pp. 1872 - 1879
Main Authors:	Tovo, PA, Pembrey, L, Newell, ML, Amoroso, A, Asensi-Botet, F, Pereda, A, Balossini, V, Bona, G, Zaffaroni, M, Bandelloni, A, Coscia, A, Fabris, C, Aime, S, Belloni, C, Bossi, G, Salati, B, Boucher, C, Buffolano, W, Butler, K, Roura, LC, Sanges, JMB, Cigna, P, Ciria, LM, Ginard, CS, Teruel, GC, Fortuny, C, Coll, O, Corrias, A, Ledda, R, Floris, S, De Maria, A, Echeverria, J, Cilla, G, Faldella, G, Lanari, M, Tridapalli, E, Venturi, V, Fischler, B, Bohlin, AB, Lindgren, S, Lindh, G, Giacomet, V, Merlo, M, Figini, C, Erba, P, Vigano, A, Hannam, S, Mieli-Vergani, G, Hatzakis, A, Inchley, C, Fjaerli, HO, Maccabruni, A, Marcellini, M, Sartorelli, MR, Fontelos, PM, Mazza, A, Mok, JYQ, Mur, A, Vinolas, M, Paternoster, DM, Grella, P, Polywka, S, Quinti, I, Casadei, AM, Rojahn, A, Berg, A, Rosso, R, Ferrando, S, Bassetti, D, Contreras, JR, Manzanares, A, Extremera, AR, Salvini, F, Zuccotti, GV, Schmitz, T, Grosch-Worner, I, Sperling, CF, Piening, T, Vegnente, A, Iorio, R, Versace, A, Garetto, S, Lazier, L, Bressio, S, Riva, C, Alfarano, A, Wejstal, R, Norkrans, G, Zanetti, A, Tanzi, E
Format:	Journal Article Conference Proceeding
Language:	English
Published:	United States The University of Chicago Press 01-12-2005 University of Chicago Press Oxford University Press
Subjects:	Adult Cesarean Section Children Confidence Intervals Delivery, Obstetric Disease transmission Elective Surgical Procedures Europe Female Hepacivirus Hepacivirus - genetics Hepacivirus - isolation & purification Hepacivirus - pathogenicity Hepatitis C - complications Hepatitis C - epidemiology Hepatitis C - transmission Hepatitis C - virology Hepatitis C virus Highly active antiretroviral therapy HIV HIV Infections - complications Humans Infant Infant, Newborn Infant, Premature Infant, Premature, Diseases - epidemiology Infant, Premature, Diseases - virology Infections Infectious Disease Transmission, Vertical Male Medicin och hälsovetenskap Odds Ratio Pediatrics Predisposing factors Pregnancy Pregnancy Complications, Infectious - virology Prospective Studies Risk Factors Sex Factors Vertical disease transmission Viruses Women Europe
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Summary:	BackgroundRisk factors for mother-to-child transmission of hepatitis C virus (HCV) are poorly quantified Methods.We conducted a European multicenter prospective study of HCV-infected pregnant women and their infants. Children with ⩾2 positive HCV RNA polymerase chain reaction test results and/or anti-HCV antibodies after 18 months of age were considered to be infected ResultsThe overall HCV vertical transmission rate was 6.2% (95% confidence interval [CI], 5.0%–7.5%; 91/1479). Girls were twice as likely to be infected as boys (adjusted odds ratio [OR], 2.07 [95% CI, 1.23–3.48]; P=.006). There was no protective effect of elective cesarean section (CS) delivery on HCV vertical transmission (adjusted OR, 1.46 [95% CI, 0.86–2.48]; P=.16). HCV/human immunodeficiency virus–coinfected women more frequently transmitted HCV than did women with HCV infection only, although the difference was not statistically significant (adjusted OR, 1.82 [95% CI, 0.94–3.52]; P=.08). Maternal history of injection drug use, prematurity, and breast-feeding were not significantly associated with transmission. Transmission occurred more frequently from viremic women, but it also occurred from a few nonviremic women ConclusionsOur results strongly suggest that women should neither be offered an elective CS nor be discouraged from breast-feeding on the basis of HCV infection alone. The sex association is an intriguing finding that probably reflects biological differences in susceptibility or response to infection
Bibliography:	istex:2F3C569058ECC1B1821AAA37D340CA6BF9BD9892 ark:/67375/HXZ-KQN8G018-S ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0022-1899 1537-6613
DOI:	10.1086/497695