[Mother-to-infant HCV transmission. Can we influence the frequency and the course of the infection?].

AIM

To estimate the management of HCV infected women and their children.

METHODS

Part I/: Blood samples were collected from 544 pregnant women and tested for anti-HCV. Part II/: Data of risk factors of HCV infection, reasons of HCV diagnostics were assessed in 281 mothers infected with HCV, not infected with HIV. 317 children born to HCV infected mothers were observed from birth until age 2.5-10 years (testing of HCV-RNA, ALT). 26 (8.%) of them were infected with HCV.

RESULTS

Part I/: 22.02% of tested pregnant women were anti-HCV(+). Part II/: Presence of risk factors for HCV infection in anamnesis was the reason of HCV diagnostics in 34% of women. None of HCV-RNA(-) women transmitted HCV to their child. The rate of HCV infection in infants born to HCV-RNA(+) mothers was 14.1% and was higher in case of natural delivery (19.2%) compared to cesarean section (7.5%). Intrapartum percutaneus exposure to maternal blood increased transmission rates. All children born via elective cesarean section (in 38 Hbd) were HCV-RNA(-). None of infected children had clinical symptoms of hepatitis, however, one of them had mild changes in liver histopathology.

CONCLUSIONS

Antenatal screening of anti-HCV is not necessary, however, every woman with risk factors for HCV infection in anamnesis should be tested. Women infected with HCV ought to be treated before pregnancy in order to decrease HCV replication. The protective role of elective cesarean section requires further investigation. A number of children with chronic HCV infection should be considered for early treatment.