Epidemiology

Vertical HCV transmission may occur more often among female infants

Last Updated: 2005-12-15 13:33:38 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Results of a large prospective European study hint that mother-to-child transmission of hepatitis C virus (HCV) occurs significantly more often among girls than among boys.

The results, based on 1,787 HCV-infected pregnant women and their infants at 33 centers, also "strongly suggest," the authors say, that women should not be encouraged to undergo elective cesarean section or discouraged from breast feeding solely in the hopes of preventing mother-to-child HCV transmission.

The overall HCV vertical transmission rate for the cohort was low (6.2%), Dr. Pier-Angelo Tovo from the University of Turin in Italy and colleagues report in the December 1st Journal of Infectious Diseases.

According to the team, elective cesarean section did not protect against HCV transmission. Maternal history of injection drug use, prematurity, and breast-feeding were also not significantly associated with mother-to-child HCV transmission. HCV transmission occurred more often in viremic women, but it also occurred in a few nonviremic women.

As mentioned, Dr. Tovo and colleagues did find that girls were twice as likely to be infected with HCV as boys. To their knowledge, this is the first report of a significant association between sex and HCV vertical transmission.

The sex association is "an intriguing finding" that probably reflects hormonal or genetic differences in susceptibility or response to infection between males and females, they suggest.

In a related editorial, Dr. R. Palmer Beasley from the University of Texas in Houston says the higher HCV infection rates in female infants of HCV-infected mothers is "interesting, provocative, and worth further investigation." This finding, the author further notes, is in accord with recent observations of similar excesses of HIV infections in infant girls of HIV-infected mothers.

J Infect Dis 2005;192:1865-1866,1872-1879.