Severity of Hepatitis C and HIV Co-infection in Mothers Contribute to HCV Transmission to Child

[Guest guest]

http://www.infectioncontroltoday.com/news/2011/04/severity-of-hepatitis-c-and-hi\

v-co-infection-in-mothers-contribute-to-hcv-transmission-to-child.aspx

Severity of Hepatitis C and HIV Co-infection in Mothers Contribute to HCV

Transmission to Child

New research shows that high maternal viral load and co-infection with human

immunodeficiency virus (HIV) are the only risk factors associated with vertical

transmission of the hepatitis C virus (HCV-VT). A variation in the infant's

IL28B gene (CC) is associated independently with the spontaneous clearance of

HCV genotype-1 among infected children. The status of IL28B in the mother or

children did not increase risk of HCV-VT in this study. Findings are published

in the May issue of Hepatology, a journal of the American Association for the

Study of Liver Diseases.

Chronic HCV affects 170 million individuals worldwide, with 10 percent to 15

percent of cases leading to cirrhosis and liver cancer. A major route of

infection in children is vertical transmission of HCV (HCV-VT)—known also as

mother-to-child transmission—and may occur in utero or following birth (breast

feeding). While medical evidence has described risk factors involved in HCV-VT,

underlying transmission mechanisms and timing of disease transmission is not

fully understood. Prior studies have investigated the relationship between

HCV-VT and maternal HCV genotype, birth mode (vaginal or caesarean) and type of

feeding (breast feeding or replacement), but results have been conflicting.

" Our study analyzed the role of IL28B in HCV-VT and the spontaneous clearance of

HCV among infected infants, " says Ángeles Ruiz Extremera, MD, of San Cecilio

University Hospital in Spain. The team recruited 145 mothers who were infected

with HCV and gave birth between 1991 and 2009. All women were Caucasian—112 were

HCV RNA positive and HIV negative; 33 were HCV RNA negative and HCV antibody

positive. A total of 142 children were birthed by HCV-RNA positive mothers and

43 children to HCV-RNA negative mothers, all of whom were followed for six years

or more. HCV-VT was defined as children who presented with HCV-RNA positive

results from two blood samples.

Analysis showed that 61 percent of the 31 mothers with CC polymorphism, and 82

percent of the 68 mothers with non-CC polymorphism were HCV-RNA positive. There

were 128 infants born to HCV-RNA positive mothers who were not co-infected with

HIV and 20% of the children acquired HCV infection, with 7 percent of these

being chronic cases. In mothers who were coinfected with HCV and HIV, the HCV-VT

rate climbed to 43 percent. Researchers also noted that the rate of HCV-VT was

higher among mothers who had elevated HCV viremia levels. Researchers did not

detect HCV-VT in HCV-RNA negative mothers.

An increased risk of HCV-VT was not associated with the mothers' or children's

IL28B status. However, researchers found that genotype non-1 and CC of the IL28B

gene were involved with viral clearance among children infected with HCV. In

regression analysis the child CC polymorphism was the only predictor of

spontaneous HCV clearance in HCV genotype-1.

" Our data are the first to account for HCV virus clearance and may provide

important information about protective immunity to HCV, " concludes Extremera.

" Further investigation is needed to understand the mechanisms involved with this

genetic variation and the clinical impact of the IL28B variant on HCV

infection. "

Reference: Genetic Variation in IL28B with respect to Vertical Transmission of

Hepatitis C Virus and Spontaneous Clearance in HCV Infected Children. " Angeles

Ruiz-Extremera, Munoz-Gamez, Angustias Salmeron-Ruiz, Paloma

Munoz de Rueda, Quiles-, Ana Gila-Medina, Casado, Ana Belen

, Sanjuan-Nunez, Angel Carazo, Esther Pavon, Esther Ocete-Hita,

fa Leon, Salmeron. Hepatology; Published Online: March 16, 2011 (DOI:

10.1002/hep.24298); Print Issue Date: May 2011.

http://onlinelibrary.wiley.com/doi/10.1002/hep.24298/abstract.

[Guest guest]

http://www.infectioncontroltoday.com/news/2011/04/severity-of-hepatitis-c-and-hi\

v-co-infection-in-mothers-contribute-to-hcv-transmission-to-child.aspx

Severity of Hepatitis C and HIV Co-infection in Mothers Contribute to HCV

Transmission to Child

New research shows that high maternal viral load and co-infection with human

immunodeficiency virus (HIV) are the only risk factors associated with vertical

transmission of the hepatitis C virus (HCV-VT). A variation in the infant's

IL28B gene (CC) is associated independently with the spontaneous clearance of

HCV genotype-1 among infected children. The status of IL28B in the mother or

children did not increase risk of HCV-VT in this study. Findings are published

in the May issue of Hepatology, a journal of the American Association for the

Study of Liver Diseases.

Chronic HCV affects 170 million individuals worldwide, with 10 percent to 15

percent of cases leading to cirrhosis and liver cancer. A major route of

infection in children is vertical transmission of HCV (HCV-VT)—known also as

mother-to-child transmission—and may occur in utero or following birth (breast

feeding). While medical evidence has described risk factors involved in HCV-VT,

underlying transmission mechanisms and timing of disease transmission is not

fully understood. Prior studies have investigated the relationship between

HCV-VT and maternal HCV genotype, birth mode (vaginal or caesarean) and type of

feeding (breast feeding or replacement), but results have been conflicting.

" Our study analyzed the role of IL28B in HCV-VT and the spontaneous clearance of

HCV among infected infants, " says Ángeles Ruiz Extremera, MD, of San Cecilio

University Hospital in Spain. The team recruited 145 mothers who were infected

with HCV and gave birth between 1991 and 2009. All women were Caucasian—112 were

HCV RNA positive and HIV negative; 33 were HCV RNA negative and HCV antibody

positive. A total of 142 children were birthed by HCV-RNA positive mothers and

43 children to HCV-RNA negative mothers, all of whom were followed for six years

or more. HCV-VT was defined as children who presented with HCV-RNA positive

results from two blood samples.

Analysis showed that 61 percent of the 31 mothers with CC polymorphism, and 82

percent of the 68 mothers with non-CC polymorphism were HCV-RNA positive. There

were 128 infants born to HCV-RNA positive mothers who were not co-infected with

HIV and 20% of the children acquired HCV infection, with 7 percent of these

being chronic cases. In mothers who were coinfected with HCV and HIV, the HCV-VT

rate climbed to 43 percent. Researchers also noted that the rate of HCV-VT was

higher among mothers who had elevated HCV viremia levels. Researchers did not

detect HCV-VT in HCV-RNA negative mothers.

An increased risk of HCV-VT was not associated with the mothers' or children's

IL28B status. However, researchers found that genotype non-1 and CC of the IL28B

gene were involved with viral clearance among children infected with HCV. In

regression analysis the child CC polymorphism was the only predictor of

spontaneous HCV clearance in HCV genotype-1.

" Our data are the first to account for HCV virus clearance and may provide

important information about protective immunity to HCV, " concludes Extremera.

" Further investigation is needed to understand the mechanisms involved with this

genetic variation and the clinical impact of the IL28B variant on HCV

infection. "

Reference: Genetic Variation in IL28B with respect to Vertical Transmission of

Hepatitis C Virus and Spontaneous Clearance in HCV Infected Children. " Angeles

Ruiz-Extremera, Munoz-Gamez, Angustias Salmeron-Ruiz, Paloma

Munoz de Rueda, Quiles-, Ana Gila-Medina, Casado, Ana Belen

, Sanjuan-Nunez, Angel Carazo, Esther Pavon, Esther Ocete-Hita,

fa Leon, Salmeron. Hepatology; Published Online: March 16, 2011 (DOI:

10.1002/hep.24298); Print Issue Date: May 2011.

http://onlinelibrary.wiley.com/doi/10.1002/hep.24298/abstract.