Vertical transmission of HCV.

BACKGROUND: Knowledge about vertical transmission of HCV is still limited. In this study we followed up the virological status of a series of offspring born to anti-HCV positive, anti-HIV negative mothers. METHODS: Between January 1993 and January 1995, 5000 consecutive, anti-HIV negative pregnant women were screened for anti-HCV (ELISA III) and all positive samples were confirmed by RIBA III and analyzed for HCV-RNA by polymerase chain reaction (PCR). Babies born to anti-HCV positive mothers were followed from birth to two years by testing for ALT levels, anti-HCV antibodies and HCV-RNA. RESULTS: Of 5000 mothers 80 (1.6%) were anti-HCV positive (ELISA III) and RIBA III positive. Of these, 56 (70%) were HCV-RNA positive. We examined 80 babies, born to anti-HCV positive mothers: 56 with HCV-RNA positive mothers and 24 with HCV-RNA negative mothers. Two babies (3.6%) of 56 were anti-HCV and HCV-RNA positive, with normal liver function tests. Seventy-eight babies (97.5%) of 80 (54 with HCV-RNA positive mothers and 24 with HCV-RNA negative mothers) were HCV-RNA negative, with normal liver function tests and detectable levels of anti-HCV antibodies that gradually disappeared between 8-12 months. CONCLUSION: Mother-to-infant transmission of HCV is possible only in the case of HCV-RNA positive mothers. In our study the rate of transmission is 3.6%, (2/56 babies with HCV-RNA positive mothers). HCV transmission may occur without evident association with breast-feeding or vaginal delivery.