丙型肝炎病毒从母亲到婴儿的传播。丙型肝炎病毒垂直传播协作研究组。

Transmission of hepatitis C virus from mothers to infants. The Vertical Transmission of Hepatitis C Virus Collaborative Study Group.

作者信息

Ohto H, Terazawa S, Sasaki N, Sasaki N, Hino K, Ishiwata C, Kako M, Ujiie N, Endo C, Matsui A

机构信息

Blood Transfusion Service, Fukushima Medical College, Japan.

出版信息

N Engl J Med. 1994 Mar 17;330(11):744-50. doi: 10.1056/NEJM199403173301103.

DOI:10.1056/NEJM199403173301103

PMID:8107740

Abstract

BACKGROUND

Although there are case reports of vertical transmission of hepatitis C virus (HCV), it remains uncertain to what extent infected mothers transmit this virus to their infants.

METHODS

We investigated the transmission of HCV from infected mothers to their babies by analyzing HCV RNA in the blood. Three independent studies were performed. First, 7698 parturient women were tested for anti-HCV antibodies; 53 were positive. Their 54 infants (including one set of twins) were followed prospectively for at least six months and tested for HCV disease were prospectively studied. Third, the families of three HCV-infected infants were examined retrospectively.

RESULTS

Of the 53 antibody-positive mothers, 31 were also positive for serum HCV RNA: Three of the 54 babies born to these mothers (5.6 percent) became positive for HCV RNA during the follow-up period. None of the babies of the 22 women who were antibody-positive but HCV RNA-negative became positive for HCV RNA: In the second study, HCV RNA was detected in one of the six infants of infected mothers. In the third study, HCV RNA was detected in the mothers of the three HCV-infected infants. In each of the seven infected infants we studied, the genomic sequence of HCV was almost identical to that from the mother. These seven mothers had significantly higher titers of HCV RNA than did the mothers of infants with no evidence of infection (mean [+/- SD], 10(6.4 +/- 0.5) vs. 10(4.4 +/- 1.5) per milliliter; P < 0.001).

CONCLUSIONS

HCV is vertically transmitted from mother to infant, and the risk of transmission is correlated with the titer of HCV RNA in the mother.

摘要

背景

虽然有丙型肝炎病毒（HCV）垂直传播的病例报告，但受感染母亲将该病毒传播给其婴儿的程度仍不确定。

方法

我们通过分析血液中的HCV RNA来研究HCV从受感染母亲向其婴儿的传播。进行了三项独立研究。首先，对7698名产妇进行了抗HCV抗体检测；53人呈阳性。对她们的54名婴儿（包括一对双胞胎）进行了至少六个月的前瞻性随访，并对HCV疾病进行了前瞻性研究。第三，对三名HCV感染婴儿的家庭进行了回顾性检查。

结果

在53名抗体阳性母亲中，31名血清HCV RNA也呈阳性：这些母亲所生的54名婴儿中有3名（5.6%）在随访期间HCV RNA呈阳性。22名抗体阳性但HCV RNA阴性的妇女所生的婴儿中，没有一名HCV RNA呈阳性：在第二项研究中，在受感染母亲的六名婴儿中有一名检测到HCV RNA。在第三项研究中，在三名HCV感染婴儿的母亲中检测到HCV RNA。在我们研究的七名受感染婴儿中，每一名婴儿的HCV基因组序列与母亲的几乎相同。这七名母亲的HCV RNA滴度明显高于没有感染迹象的婴儿的母亲（平均值[±标准差]，每毫升10(6.4±0.5) 与10(4.4±1.5)；P<0.001）。