Vertical transmission of hepatitis C virus in low to middle socio-economic pregnant population of Karachi

Abstract

Purpose To determine the rate of vertical transmission (transmission from mother to child) of hepatitis C virus in low to middle socio-economic pregnant women. Methods This study was conducted at Sarwar Zuberi Liver Centre (SZLC) in collaboration with the department of Gynaecology and Obstetrics, Civil Hospital Karachi (CHK) and Abbasi Shaheed Hospital (ASH) for a period of 4 years from September 2005 to December 2009. Total 18,000 women seeking antenatal care were screened for hepatitis C antibodies (Anti-HCV) using 4th generation ELISA technique. Positive 1,043 women were further offered HCV ribonucleic acid (RNA) by polymerase chain reaction (PCR). Six hundred and forty women agreed to have PCR done, and 510 PCR positive women were finally included in the study, followed till delivery and treated if required. Newborns of 510 PCR positive mothers were advised HCV-RNA by PCR from 3 to 12 months of age and Anti-HCV at 18 up to 24 months and followed up to 3 years.Results 1,043/18,000 (5.79%) mothers were Anti-HCV positive, of which PCR results of 640 mothers are available where 510/640 (79.7%) were PCR positive, 357/510 (70%) delivered by spontaneous vaginal delivery (SVD), 33 (6.4%) by forceps delivery, 70 (13.7%) had elective, and 50 (9.8%) had emergency caesarian section. Premature rupture of membranes (PROM) was present in 81 mothers. Data of 510 babies from 3 months to 3 years of age was available of which only 215 had their laboratory tests done (HCV-RNA-PCR in 86 and Anti-HCV in 129). Mean birth weight (kg), height (cm) and OFC (cm) were 2.74 ± 0.43, 52.4 ± 7.5, and 35 ± 4. Apgar score median at 1 and 5 min was 7 (range 2-10), 8 (range 4-10), respectively. Low birth weight was present in 49 (9.6%), 37 (7.2%) had history of Neonatal Intensive Care Unit (NICU) admission. PCR of none of the 86 babies done at 3-12 months was positive. Five babies out of 129 were Anti-HCV positive at 18 months of age. Of this, 3/5 was HCV-RNA-PCR positive. Rate of vertical transmission of HCV was 1.39. Conclusion In spite of the high hepatitis C positivity in pregnant population, the rate of vertical transmission to the neonate is low.

Hepatitis C virus infection of human cytotrophoblasts cultured in vitro

“…In order to study each material entering the embryo through the placental membrane, cultured human placenta cytotrophoblasts have been isolated in vitro to lay the cytological foundation [Indolfi et al, 2007]. Maternal–fetal HCV transmission is an important topic [AbdulQawi et al, 2010; Aziz et al, 2011], one which the current paper aims to investigate. HCV passes through the placenta to infect the embryo [Martinetti et al, 2006].…”

Frequency of HCV Infection in Children of HCV Infected Mothers

“…In fact, the rates of transmission varied from 0-30%. This large variability is probably due to differences in study size (e.g., the number of HCV-infected mothers enrolled), the study methodology (prospective or retrospective study, detection of maternal infection based on anti-HCV antibody positivity or on HCV RNA positivity) and the diagnostic criteria of neonatal HCV infection (e.g., number of polymerase chain reactions performed and duration and timing of follow up in the neonates) (Yeung et al, 2001;Arshad et al, 2011;Aziz et al, 2011).…”

Computational analysis to predict functional role ofhsa-miR-3065-3pas an antiviral therapeutic agent for treatment of triple infections: HCV, HIV-1, and HBV

“…Pakistan has an overall HIV-1 prevalence of 0.1%, but within certain high risk groups, such as IDUs and MSM (men who have sex with men); concentrated HIV-1 epidemics exist in certain parts of Pakistan–Afghanistan border areas and amongst the refugees where the prevalence of HIV is 2–3% (4–6, 27, 28). Limited data exist on the prevalence of HIV-1, HCV, and HBV in neighboring Afghanistan (27, 28). IDUs, MSM, commercial sex workers, migrant workers, and prisoners are recognized as subgroups at high risk for TI among the Afghan natives and among refugee populations (27).…”