Dal Molin Gianna, D'Agaro Pierlanfranco, Ansaldi Filippo, Ciana Giovanni, Fertz Cristina, Alberico Salvatore, Campello Cesare
Department of Public Medicine Sciences, U.C.O. Hygiene and Preventive Medicine, University of Trieste and IRCCS Burlo Garofolo, Trieste, Italy.
J Med Virol. 2002 Jun;67(2):137-42. doi: 10.1002/jmv.2202.
One hundred twenty-six mother-infant couples were studied and 105 exposed babies were monitored for at least 12 months to define the risk of mother-to-infant HCV transmission. Infection occurred in 5 out of 76 infants (6.6%) born to 69 viraemic mothers and in none of 29 born to 26 non-viraemic mothers. Only one child was HCV RNA positive one month after birth, while the remaining children became positive at the 3rd to 4th month. HCV genotypes of the babies matched those of their mothers. No difference was found between women who transmitted the virus and those who did not with regard to age, history of drug abuse, HIV infection, ALT abnormal values, HCV genotype, type of delivery, and breast-feeding. Four out of 5 infected infants were born to mothers with IgM anti-HCV (P = 0.04). The mean viral titre in transmitting women (10(7.2)) was higher than in non-transmitting (10(6.5)), and the proportion of mothers with viral load > or = 10(7) was statistically higher in transmitting than non-transmitting women (P = 0.03). These data show that HCV perinatal infection is a rare event and suggest that IgM positivity and high viral load (> or = 10(7)) in the mother are independent variables correlated with HCV transmission (O.R. = 14.5; 95% CI: 1.3-160.7 and O.R. = 16.3; 95% CI: 1.5-179.9, respectively).
对126对母婴进行了研究，对105名暴露婴儿进行了至少12个月的监测，以确定母婴丙型肝炎病毒传播的风险。69名病毒血症母亲所生的76名婴儿中有5名（6.6%）感染，26名非病毒血症母亲所生的29名婴儿均未感染。只有一名儿童出生后1个月丙型肝炎病毒RNA呈阳性，其余儿童在第3至4个月呈阳性。婴儿的丙型肝炎病毒基因型与母亲的基因型匹配。在病毒传播者和未传播者之间，在年龄、药物滥用史、艾滋病毒感染、丙氨酸转氨酶异常值、丙型肝炎病毒基因型、分娩方式和母乳喂养方面未发现差异。5名感染婴儿中有4名出生于IgM抗丙型肝炎病毒阳性的母亲（P = 0.04）。病毒传播母亲的平均病毒滴度（10(7.2)）高于未传播母亲（10(6.5)），病毒载量≥10(7)的母亲在病毒传播者中的比例在统计学上高于未传播者（P = 0.03）。这些数据表明，丙型肝炎病毒围产期感染是一种罕见事件，并表明母亲的IgM阳性和高病毒载量（≥10(7)）是与丙型肝炎病毒传播相关的独立变量（比值比分别为14.5；95%可信区间：1.3 - 160.7和16.3；95%可信区间：1.5 - 179.9）。
