丙型肝炎母婴传播何时发生

作     者：Mok J. Pembrey L. Tovo P.- A. Newell M.- L. 朱新菊 

作者机构：Ctr. Paediatr. Epidemiol./Biostat. Institute of Child Health University College London 30 Guilford Street London WC1N 1EH United Kingdom Prof. 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2005年第1卷第8期

页      面：18-18页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：母婴传播 丙型肝炎 宫内感染 婴儿出生体重 定群研究 丙肝病毒 出生后 多聚酶链反应 病毒感染 混合感染 

摘      要：Objective: To investigate when hepatitis C virus (HCV) infection from mother to child occurs, and evaluate possible associafed factors. Design: Prospective c ohort study. Patients: Fifty four HCV infected children tested within three days of birth and their mothers. Main outcome measures: HCV RNA polymerase chain rea ction (PCR) results. Results: Seventeen of the children (31% , 95% confidence interval 19% to 46% )- were positive in the first 3 days of life and could be assumed to have acquired infection in utero. Testing PCR positive was not ass ociated with sex (53% v 49% boys; p = 0.77) or mode of delivery (29% elect ive caesarean section in both groups; p = 0.98). Children with evidence of intra uterine infection were significantly more likely to be of lower birthweight and infected with genotype 1 (58% v 12% , p = 0.01). Although a higher proportion of infants born to HCV/HIV co- infected women were PCR positive in the first 3 days of life, this difference did not reach statistical significance; excluding infants born to co- infected women did not affect the results. Thirty seven of the children (68% ) were negative in the first 3 days of life, 27 of whom were positive when tested again at 3 months, and nine were first PCR positive after 3 months (one child had no further tests). Conclusions: These results suggest th at at least one third and up to a half of infected children acquired infection i n utero. Although postpartum transmission cannot be excluded, these data suggest that it is rare. The role of HCV genotypes in the timing and mechanism of infec tion should be explored further.