Effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus: European Paediatric Hepatitis C Virus Network

P. A. Tovo, M. L. Newell, O. Coll, B. Martinez de Tejada, M. Lanari, I. Bosi, I. Papa, A. Zanetti, J. Ruiz Contreras, A. Manzanares, J. T. Ramos, A. Vegnente, R. Iorio, C. Fabris, A. M. Bandelloni, C. Tibaldi, L. M. Ciria, E. Palomba, C. Riva, C. ScolfaroW. Buffolano, I. Scotese, A. Micco, M. Marcellini, M. R. Sartorelli, S. Mattia, A. B. Bohlin, B. Fischler, S. Lindgren, G. Lindh, A. Maccabruni, I. Pacati, L. Arlandi, S. Polywka, K. Butler, A. De Maria, D. Bassetti, F. Fioredda, S. Boni, C. Gotta, A. Mazza, I. Grosch-Wörner, C. Feiterna Sperling, I. Quinti, G. Scaravelli, P. Cigna, G. Cilla, J. Echeverria, H. Souayah, D. Grossman, J. Levy, G. Bona, J. Y.Q. Mok, P. Martin Fontelos, J. Villota Arrieta, F. Asensi-Botet, M. C. Otero, D. Pérez-Tamarit, G. Zuin, B. Saccani, G. V. Zuccotti, E. Riva, A. Gamboni, R. Wejstal, G. Norkrans, H. Scherpbier, A. Mûr, M. Viñolas, A. Ruiz Extremera, L. Cabero Roura, J. McBertran Sanges, J. A. McLeon Leal, A. Rodriguez, A. Sarrión-Auñón, A. Corrias, C. Boucher, A. Hatzakis, P. Grella

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Abstract

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.
Original languageEnglish
Pages (from-to)371-377
JournalBritish Journal of Obstetrics and Gynaecology
Volume108
Issue number4
DOIs
Publication statusPublished - 1 Jan 2001

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