[Mother-to-infant HCV transmission--rate and course of HCV infection in children].

OBJECT: to establish the rate and course of HCV infection in infants born to HCV infected mothers and to determine abilities of prevention.

METHODS: 155 children born to HCV infected mothers were observed from birth until age 18-48 months. Serum of infants was tested for HCV-RNA (RT-PCR, Amplicor v 2.0 Roche), for anti-HCV (EIA v. 2) and ALT activity. Infants were classified as HCV infected if their serum was found to be positive for HCV-RNA at least twice during first year of life. In 11 mothers and their newborns serum and PBMC from venous blood and from the umbilical cord were collected during delivery and examined-using nested RT-PCR.

RESULTS: The overall HCV vertical infection rate was 11%. Transmission occurred more frequently in children with intrapartum exposure to maternal blood by percutaneus inoculation. None of the infected infants had clinical symptoms of hepatitis. ALT abnormal activity was detected in 43% of infected children. HCV-RNA was detected in mothers' serum and PBMC collected during delivery in 9 (9/11) samples. HCV-RNA was detected in samples from umbilical cord in serum in 7 (7/11) and in PBMC in 4 (4/11) cases.

CONCLUSIONS: The risk of HCV vertical infection in present study was high. Intrapartum percutaneus exposure to maternal blood increased transmission rates. Further investigation to determine the effectiveness of antiviral therapy in prevention of mother-to-infant HCV transmission should be performed. The role of PBMC in mother-to-child HCV transmission should be investigated.