Prospective cohort study of children exposed to hepatitis C virus through a pregnancy screening program

International Journal of Infectious Diseases

Maria Inês Gonzalez Solari¹  Juliana Ferraz de Correa¹  Maristela Fiorini²  Mary Catherine Cambou³  Karin Nielsen-Saines³  Kara Chew³  Ivete Cristina Teixeira Canti⁴  Breno Riegel Santos⁴  Marineide Melo⁴  Ivana Rosângela dos Santos Varella⁴  Mara Liane Rieck Silveira⁴  Raquel Borges Pinto⁵  Ana Regina L. Ramos⁵  Leidy Tovar Padua⁶  Emma Jane Swayze⁷ 

[1] Central Public Health Laboratory of Rio Grande do Sul, Porto Alegre, RS, Brazil;Communicable Disease Surveillance Team, Municipal Health Secretariat of Porto Alegre, RS, Brazil;David Geffen School of Medicine, University of California, Los Angeles, California, USA;Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil;Hospital da Criança Conceição, Porto Alegre, RS, Brazil;University of San Diego School of Medicine, University of California, San Diego, California, USA;Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA;

关键词: Brazil;    Pregnancy;    HCV screening;    Infants;    MTCT HCV;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: Porto Alegre, in south Brazil, has one of the highest hepatitis C virus (HCV) infection rates in the country (84.4 cases/100 000 in 2018). Prenatal screening of HCV, however, has not been routinely offered. Methods: A longitudinal study of pregnant women with HCV and their infants was conducted between January 2014 and December 2018. Screening for HCV antibodies was offered to all women delivering at the study tertiary institution. HCV RT-PCR was performed if the woman was seropositive. Infants were followed prospectively. Results: Among 18 953 pregnant women delivering infants during the study period, 17 810 were screened for HCV antibodies (93.9%) with 130 positive results (HCV seroprevalence 0.7%). HCV-RNA was detectable in 57/117 cases (48.7%). HCV viremia was associated with the use of injectable drugs (P = 0.03), inhaled/crack drug use (P = 0.02), having an HCV-seropositive partner, and ≥3 lifetime sexual partners (P < 0.01). Genotype 1 was most prevalent (68%) during pregnancy. Among 43 children with follow-up, six (13%) were HCV-infected (transmission rate 13.9%); 50% were infected with genotype 3. Two infants (33%) cleared their infection; the mothers had genetic polymorphisms associated with clearance. Conclusion: HCV vertical transmission was high in the study population, with HCV infection during pregnancy being vastly underdiagnosed. Public health efforts must focus on this vulnerable population for disease prevention and early treatment.

【 授权许可】

Unknown