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Войти в исследования Risk Factors for Perinatal Transmission of Hepatitis C Virus.
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Prasad Mona, Saade George R, Clifton Rebecca G, Sandoval Grecio J, Hughes Brenna L, Reddy Uma M, Bartholomew Anna, Salazar Ashley, Chien Edward K, Tita Alan T N, Thorp John M, Metz Torri D, Wapner Ronald J, Sabharwal Vishakha, Simhan Hyagriv N, Swamy Geeta K, Heyborne Kent D, Sibai Baha M, Grobman William A, El-Sayed Yasser Y, Casey Brian M, Parry Samuel, Rathore Mobeen, Diaz-Velasco Rodrigo, Puga Ana M, Wiznia Andrew, Kovacs Andrea, Garry David J, Macones George A, for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network*
Аннотация
METHODS: This was a prospective, multicenter, observational study of pregnant individuals at less than 24 weeks of gestation screened for HCV infection from 2012 to 2018 in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Individuals found to be HCV antibody-positive were followed throughout pregnancy. Children were followed for evidence of perinatal transmission at 2-6 months (HCV RNA testing) and at 18-24 months (HCV RNA and antibody testing) of life. The primary outcome was perinatal transmission, defined as positive test results at either follow-up time point.
RESULTS: A total of 109,379 individuals were screened for HCV infection. Of the 1,224 participants who screened positive, 772 (63.1%) enrolled and 432 of those 772 (56.0%) had data available to assess primary outcome. The overall rate of perinatal transmission was 6.0% (26/432, 95% CI 4.0-8.7%). All children with HCV infection were born to individuals with demonstrable viremia. In viremic participants (n=314), the perinatal transmission rate was 8.0% (95% CI 5.2-11.5%). Risk factors for perinatal transmission included HCV RNA greater than 106 international units/mL (adjusted odds ratio [aOR] 8.22, 95% CI 3.16-21.4) and vaginal bleeding reported at any time before delivery (aOR 3.26, 95% CI 1.32-8.03). A viremic threshold for perinatal transmission could not be established.
CONCLUSION: Perinatal transmission of HCV infection was limited to viremic individuals. High viral loads and antepartum bleeding were associated with perinatal transmission.