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J Infect Dis 2002;185:567-572.
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Date Posted: Thu, January 02 2003, 19:15:48 PST
In reply to:
Pediatr Infect Dis J 2001;20:10-14.
's message, "HCV Viremia at Delivery a Risk Factor for Mother-to-Infant" on Sat, March 03 2001, 15:45:53 PST
Maternal Injection Drug Use Increases Risk of Vertical Hepatitis C Transmission
NEW YORK (Reuters Health) Feb 22 - Maternal injection drug use, but not co-infection with HIV, significantly increases the risk of hepatitis C virus (HCV) transmission to a fetus, according to results of a multicenter, prospective study conducted in Italy.
A total of 1372 consecutive, unselected mothers positive for HCV antibody and their infants were identified in 24 medical centers. Ninety-eight of the offspring were infected with HCV.
Gestational age, birth weight, breast-feeding, and method of delivery were unrelated to transmission rates, Dr. Massimo Resti, of the University of Florence and Pediatric Hospital A. Meyer, and associates report in March 1st issue of The Journal of Infectious Diseases. Multivariate analysis showed that only injection drug use was significantly associated with HCV transmission (p = 0.0002).
Transmission rates were similar for mothers who were seropositive or seronegative for HIV. However, the investigators note that "maternal HIV-1 positivity and history of injection drug use appear to be strictly related (p < 0.000001). This finding could account for previous reports suggesting that HIV seropositivity increases the risk of HCV vertical transmission.
It made no difference in outcome whether the mother continued injecting drugs during pregnancy or quit prior to becoming pregnant. Dr. Resti's group suggests that mononuclear cell infection by HCV is higher in those who inject drugs. Another explanation they offer is that individuals who inject drugs are subject to repeated superinfections with different HCV variants, some of which may have selective advantages in the infection of offspring.
The investigators conclude, "All anti-HCV-positive women with a history of past or active drug addiction should be advised that, independently of HIV-1 co-infection, they are at higher risk of infecting their offspring."
J Infect Dis 2002;185:567-572.
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