Περίληψη:
Objective: To investigate the effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus. Design: Pooled retrospective analysis of prospectively collected data. Sample: Data on hepatitis C virus seropositive mothers and their children identified around delivery were sent from 24 centres of the European Paediatric Hepatitis C Virus Network. Main outcome measures: Hepatitis C virus infection status of children born to hepatitis C virus infected women. Results: A total of 1,474 hepatitis C virus infected women were identified, of whom 503 (35%) were co-infected with HIV. Co-infected women were more than twice as likely to transmit hepatitis C virus to their children than women with hepatitis C virus infection alone. Overall 9.2% (136/1474) of children were hepatitis C virus infected. Among the women with hepatitis C virus infection-only, multivariate analyses did not show a significant effect of mode of delivery and breastfeeding: caesarean section vs vaginal delivery OR = 1.17, P: 0.66; breastfed versus non-breastfed OR = 1.07, P = 0.83. However, HIV co-infected women delivered by caesarean section were 60% less likely to have an infected child than those delivered vaginally (OR = 0.36, P = 0.01) and those who breastfed were about four times more likely to infect their children than those who did not (OR = 6.41, P: 0.03). HIV infected children were three to four times more likely also to be hepatitis C virus infected than children without HIV infection (crude OR = 3.76, 95% CI 1.89-7.41). Conclusions: These results do not support a recommendation of elective caesarean section or avoidance of breastfeeding for women with hepatitis C virus infection only, but the case for HIV infected women undergoing caesarean section delivery and avoiding breastfeeding is strengthened if they are also hepatitis C virus infected.
Συγγραφείς:
Tovo, P.-A.
Newell, M.-L.
Coll, O.
de Tejada, B.M.
Lanari, M.
Bosi, I.
Papa, I.
Zanetti, A.
Contreras, J.R.
Manzanares, A.
Ramos, J.T.
Vegnente, A.
Iorio, R.
Fabris, C.
Bandelloni, A.M.
Tibaldi, C.
Ciria, L.M.
Palomba, E.
Riva, C.
Scolfaro, C.
Buffolano, W.
Scotese, I.
Micco, A.
Marcellini, M.
Sartorelli, M.R.
Mattia, S.
Bohlin, A.-B.
Fischler, B.
Lindgren, S.
Lindh, G.
Maccabruni, A.
Pacati, I.
Arlandi, L.
Polywka, S.
Butler, K.
De Maria, A.
Bassetti, D.
Fioredda, F.
Boni, S.
Gotta, C.
Mazza, A.
Grosch-Wörner, I.
Sperling, C.F.
Quinti, I.
Scaravelli, G.
Cigna, P.
Cilla, G.
Echeverria, J.
Souayah, H.
Grossman, D.
Levy, J.
Bona, G.
Mok, J.Y.Q.
Fontelos, P.M.
Arrieta, J.V.
Asensi-Botet, F.
Otero, M.C.
Pérez-Tamarit, D.
Zuin, G.
Saccani, B.
Zuccotti, G.V.
Riva, E.
Gamboni, A.
Wejstal, R.
Norkrans, G.
Scherpbier, H.
Mûr, A.
Viñolas, M.
Extremera, A.R.
Roura, L.C.
McBertran Sanges, J.
McLeon Leal, J.A.
Rodriguez, A.
Sarrión-Auñón, A.
Corrias, A.
Boucher, C.
Hatzakis, A.
Grella, P.
