September 4, 2013

Maternal transmission cause of HCV in children

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Indolfi G. J Pediatr. 2013;doi:10.1016/j.jpeds.2013.06.077.

September 4, 2013

Mother-to-child transmission is the leading causes of hepatitis C virus infection in children, according to recent findings published in The Journal of Pediatrics.

“Mother-to-child transmission of HCV is defined as transmission occurring during pregnancy or in the perinatal period from the HCV-infected mother to the fetus or to the child,” according to background information in the study. “The exact timing and the ultimate mechanism of mother-to-child transmission of HCV infection are unknown. Among children acquiring infections from the mother, only a few have been found to be HCV-RNA positive in the first days of life.”

Transmission of HCV is more likely to occur if the mothers had a history of IV drug use, were coinfected with HIV, and had higher liver disease activity as defined by the presence of elevated aminotransferase levels. The major risk factors for perinatal transmission of HCV were shown to be dependent on peripheral blood mononuclear cell (PBMC) infection with HCV.

“HCV-infected maternal PBMCs can be the carrier of the virus inside the child, serving as a Trojan horse for HCV entry,” researchers wrote. “Once inside the child, the efficiency of transmission is dependent on the infection of newborn target cells that in turn is related to the persistence of maternal-infected cells in fetal/neonatal blood.”

However, because transmission is not completely understood, no effective prevention intervention is currently available.

”Perinatal transmission of HCV is a complex and almost unexplained phenomenon,” Giuseppe Infoldi, MD, of Meyer Children’s University Hospital of Florence, told Infectious Diseases in Children. “Further research and attention by clinicians is needed in the future for the leading route of acquisition of HCV infection in children.”

Disclosure: The researchers report no relevant financial disclosures.

Giuseppe Indolfi, MD, can be reached at Meyere Children’s University Hospital of Florence, Viale Pieraccini 34, I-50139, Florence, Italy; email: g.indolfi@meyer.it

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