TITLE: Role of breast-feeding in transmission of
hepatitis C virus to infants of HCV-infected mothers.
BACKGROUND/AIMS: The aim of this study was to explore the role
of breast-feeding in transmission of hepatitis C virus (HCV) to
infants of HCV-infected mothers.
METHODS: Sixty-five parturient asymptomatic carrier mothers with
anti-HCV antibody (index patients) and 42 healthy parturient
anti-HCV negative mothers (control subjects) were studied from
September 1994 to June 1996. Maternal blood and colostrum were
taken from each subject within 5 days post-partum and tested for
anti-HCV and HCV RNA. Blood samples were collected from all infants
at birth (cord blood) and at 1, 3, 6, 9 and 12 months of age. All
infants were breast-fed. By 3 months post-partum, five of 65 index
patients developed symptomatic liver disease and three of their
infants developed acute viral hepatitis. Genotyping and subsequent
nucleotide sequencing of the hepatitis C genome was done on these
three symptomatic mother-baby pairs.
RESULTS: Within 5 days post-partum, the 65 carrier mothers had
anti-HCV ranging from 1:40 to 1:30,000 and HCV-RNA ranging from
10(2) to 2.5x10(6) copies/ml. Both anti-HCV antibody and HCV-RNA
were present in colostral samples but in significantly lower levels
(p less than 0.0001). The five symptomatic mothers had anti-HCV
titers ranging from 1:45,000 to 1:90,000 and HCV-RNA ranging from
2.5x10(8) to 4.5x10(9) copies/ml; three of their infants were
symptomatic by 3 months of age. Hepatitis C virus genotype (3a) was
concordant within each of the three mother-baby pairs, and all
three pairs demonstrated greater than 97% homologies between pairs.
These three infants were delivered by elective cesarean section at
term, breast-fed regularly and there was no apparent maternal
breast nipple trauma. None of the remaining infants had evidence of
HCV infection up to 1 year of age. All 42 mother-infant pairs from
the control group remained anti-HCV negative throughout this
study.
CONCLUSION: Among asymptomatic mothers breast-feeding seems
safe. Symptomatic women, especially with high viral loads, should
not breast-feed to avoid the risk of viral transmission through
breast-feeding.
AUTHOR: Kumar RM, Shahul S, Department of Obstetrics and
Gynecology, Faculty of Medicine and Health Sciences, UAE
University, Al-Ain, United Arab Emirates.; SOURCE: J Hepatol 1998
Aug;29(2):191-197
Home | What is HCV | Transmission |
Future |
Complications |
Biopsy |
Treatment
| Lab |
Nutrition |
Patient |
Links | Transplant |
Webrings |
guestbookbook |
Awards |
FAQ
|