Failure to detect vertical transmission of hepatitis C virus

John F. Reinus, Enid L. Leikin, Harvey J. Alter, Ling Cheung, Michiko Shindo, Betsy Jett, Steve Piazza, J. Wai Kuo Shih

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Abstract

Objective: To search for transmission of hepatitis C virus (HCV) from infected mothers to their infants. Design: Prospective clinical, serologic, and molecular biologic follow-up (at least 3 months) of the infants of mothers with anti-HCV antibody. Setting: A county hospital providing primary and referral care in high-risk obstetrics (perinatology).Patients: Twenty-three mothers with anti-HCV antibody and their 24 infants. Methods: An enzyme-linked immunosorbent assay (EIA) and a four-antigen recombinant immunoblot assay (RIBA) were used to test for anti-HCV antibody; serum HCV RNA was measured in two independent laboratories by reverse transcription and polymerase chain reaction (PCR) using nested primers in the 5′-noncoding region. Infant samples were tested for HCV RNA by PCR at delivery and after 3 to 6 months of follow-up. Each sample was tested at least four times in two independent laboratories. Results: Twenty-nine of 648 mothers (4.5%; 95% Cl, 3.0% to 6.4%) had anti-HCV antibody; these women had 30 babies. Twenty-three mothers and their 24 babies were followed at least 3 months (mean followup, 52 weeks). Of the 23 mothers, 21 (91%; Cl, 72% to 99%) had a reactive RIBA; one woman had an indeterminate RIBA and was positive for HCV RNA by PCR. In 16 of 23 mothers (70%; Cl, 47% to 87%), PCR yielded a positive result in both laboratories. The mean maternal alanine aminotransferase (ALT) level was 1.6 times the normal value. All the babies had anti-HCV antibody in cord-blood samples, but antibody disappeared or diminished in strength in interval samples, and no infant had evidence of active production of anti-HCV antibody. Only 1 of 24 (4%; Cl, 0.1% to 21%) cord-blood samples was HCV RNA positive, and none of 24 (0%; Cl, 0% to 14%) follow-up samples was positive for HCV RNA by PCR in either laboratory. Four mothers and one baby had antibody to HIV. Conclusions: Infant anti-HCV antibody is most likely acquired passively in utero, and vertical transmission of HCV is uncommon.

Original languageEnglish (US)
Pages (from-to)881-886
Number of pages6
JournalAnnals of Internal Medicine
Volume117
Issue number11
StatePublished - Dec 1992

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Hepacivirus
Hepatitis C Antibodies
Mothers
DNA-Directed RNA Polymerases
Polymerase Chain Reaction
Fetal Blood
Perinatology
RNA
County Hospitals
HIV Antibodies
Alanine Transaminase
Reverse Transcription
Obstetrics
Primary Health Care
Reference Values
Referral and Consultation
Enzyme-Linked Immunosorbent Assay
Antigens
Antibodies
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Reinus, J. F., Leikin, E. L., Alter, H. J., Cheung, L., Shindo, M., Jett, B., ... Shih, J. W. K. (1992). Failure to detect vertical transmission of hepatitis C virus. Annals of Internal Medicine, 117(11), 881-886.

Failure to detect vertical transmission of hepatitis C virus. / Reinus, John F.; Leikin, Enid L.; Alter, Harvey J.; Cheung, Ling; Shindo, Michiko; Jett, Betsy; Piazza, Steve; Shih, J. Wai Kuo.

In: Annals of Internal Medicine, Vol. 117, No. 11, 12.1992, p. 881-886.

Research output: Contribution to journalArticle

Reinus, JF, Leikin, EL, Alter, HJ, Cheung, L, Shindo, M, Jett, B, Piazza, S & Shih, JWK 1992, 'Failure to detect vertical transmission of hepatitis C virus', Annals of Internal Medicine, vol. 117, no. 11, pp. 881-886.
Reinus JF, Leikin EL, Alter HJ, Cheung L, Shindo M, Jett B et al. Failure to detect vertical transmission of hepatitis C virus. Annals of Internal Medicine. 1992 Dec;117(11):881-886.
Reinus, John F. ; Leikin, Enid L. ; Alter, Harvey J. ; Cheung, Ling ; Shindo, Michiko ; Jett, Betsy ; Piazza, Steve ; Shih, J. Wai Kuo. / Failure to detect vertical transmission of hepatitis C virus. In: Annals of Internal Medicine. 1992 ; Vol. 117, No. 11. pp. 881-886.
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abstract = "Objective: To search for transmission of hepatitis C virus (HCV) from infected mothers to their infants. Design: Prospective clinical, serologic, and molecular biologic follow-up (at least 3 months) of the infants of mothers with anti-HCV antibody. Setting: A county hospital providing primary and referral care in high-risk obstetrics (perinatology).Patients: Twenty-three mothers with anti-HCV antibody and their 24 infants. Methods: An enzyme-linked immunosorbent assay (EIA) and a four-antigen recombinant immunoblot assay (RIBA) were used to test for anti-HCV antibody; serum HCV RNA was measured in two independent laboratories by reverse transcription and polymerase chain reaction (PCR) using nested primers in the 5′-noncoding region. Infant samples were tested for HCV RNA by PCR at delivery and after 3 to 6 months of follow-up. Each sample was tested at least four times in two independent laboratories. Results: Twenty-nine of 648 mothers (4.5{\%}; 95{\%} Cl, 3.0{\%} to 6.4{\%}) had anti-HCV antibody; these women had 30 babies. Twenty-three mothers and their 24 babies were followed at least 3 months (mean followup, 52 weeks). Of the 23 mothers, 21 (91{\%}; Cl, 72{\%} to 99{\%}) had a reactive RIBA; one woman had an indeterminate RIBA and was positive for HCV RNA by PCR. In 16 of 23 mothers (70{\%}; Cl, 47{\%} to 87{\%}), PCR yielded a positive result in both laboratories. The mean maternal alanine aminotransferase (ALT) level was 1.6 times the normal value. All the babies had anti-HCV antibody in cord-blood samples, but antibody disappeared or diminished in strength in interval samples, and no infant had evidence of active production of anti-HCV antibody. Only 1 of 24 (4{\%}; Cl, 0.1{\%} to 21{\%}) cord-blood samples was HCV RNA positive, and none of 24 (0{\%}; Cl, 0{\%} to 14{\%}) follow-up samples was positive for HCV RNA by PCR in either laboratory. Four mothers and one baby had antibody to HIV. Conclusions: Infant anti-HCV antibody is most likely acquired passively in utero, and vertical transmission of HCV is uncommon.",
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AU - Reinus, John F.

AU - Leikin, Enid L.

AU - Alter, Harvey J.

AU - Cheung, Ling

AU - Shindo, Michiko

AU - Jett, Betsy

AU - Piazza, Steve

AU - Shih, J. Wai Kuo

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N2 - Objective: To search for transmission of hepatitis C virus (HCV) from infected mothers to their infants. Design: Prospective clinical, serologic, and molecular biologic follow-up (at least 3 months) of the infants of mothers with anti-HCV antibody. Setting: A county hospital providing primary and referral care in high-risk obstetrics (perinatology).Patients: Twenty-three mothers with anti-HCV antibody and their 24 infants. Methods: An enzyme-linked immunosorbent assay (EIA) and a four-antigen recombinant immunoblot assay (RIBA) were used to test for anti-HCV antibody; serum HCV RNA was measured in two independent laboratories by reverse transcription and polymerase chain reaction (PCR) using nested primers in the 5′-noncoding region. Infant samples were tested for HCV RNA by PCR at delivery and after 3 to 6 months of follow-up. Each sample was tested at least four times in two independent laboratories. Results: Twenty-nine of 648 mothers (4.5%; 95% Cl, 3.0% to 6.4%) had anti-HCV antibody; these women had 30 babies. Twenty-three mothers and their 24 babies were followed at least 3 months (mean followup, 52 weeks). Of the 23 mothers, 21 (91%; Cl, 72% to 99%) had a reactive RIBA; one woman had an indeterminate RIBA and was positive for HCV RNA by PCR. In 16 of 23 mothers (70%; Cl, 47% to 87%), PCR yielded a positive result in both laboratories. The mean maternal alanine aminotransferase (ALT) level was 1.6 times the normal value. All the babies had anti-HCV antibody in cord-blood samples, but antibody disappeared or diminished in strength in interval samples, and no infant had evidence of active production of anti-HCV antibody. Only 1 of 24 (4%; Cl, 0.1% to 21%) cord-blood samples was HCV RNA positive, and none of 24 (0%; Cl, 0% to 14%) follow-up samples was positive for HCV RNA by PCR in either laboratory. Four mothers and one baby had antibody to HIV. Conclusions: Infant anti-HCV antibody is most likely acquired passively in utero, and vertical transmission of HCV is uncommon.

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