肝病产妇丙型肝炎病毒母婴传播的可能性调查

对１９９１～１９９３年在南京市钟阜医院肝病产科住院的１０４７例肝病产妇中１２例丙型肝炎病毒抗体和／或丙型肝炎病毒核糖核酸阳性者，追踪观察了所生１２名婴儿的丙型肝炎病毒感染情况，发现１例抗－ＨＣＶ和ＨＣＶＲＮＡ均阳性的孕妇所生的婴儿，０、１、６和１２个月时抗－ＨＣＶ和ＨＣＶＲＮＡ均阳性，且该婴儿ＨＣＶ的血清型与母亲一致。结果提示，肝病产妇丙型肝炎病毒母婴传播是可能的，但不是主要的传播途径。     

Importance of sexual transmission of hepatitis C virus in seropositive pregnant women: A case-control study

The mode of hepatitis C virus (HCV) transmission in patients who deny parenteral exposure is still not understood. Seroprevalence studies of anti-HCV in sexually promiscuous populations and in spouses of infected patients have given contradictory results. We investigated the role of sexual transmission of HCV in a case-control study of risk factors for infection in a series of 43 anti-HCV positive pregnant women and 172 matched controls (4 for each case). In the univariate analysis, the following factors were associated significantly with anti-HCV seropositivity: low social class, unmarried, history of abortion, wounds which were sutured, tattooes, sharing toiletries with the partner, sexual contact outside the partnership without condom use, blood transfusion, and intravenous drug abuse, but only the last 3 factors remained significantly associated with HCV infection in multiple logistic regression analysis. The relative risk of HCV infection increased according to the increased number of sexual partners. Thus sexual transmission must be considered a possible mode of infection in HCV infected persons without parenteral exposures. J. Med. Virol. 52:164–167, 1997. © 1997 Wiley-Liss, Inc.     

Vertical transmission of woodchuck hepatitis virus

One newborn and 24 fetal woodchuck litters from a woodchuck hepatitis virus (WHV) endemic population were examined for serological or hepatic evidence of WHV. In 18 of 24 fetal litters, there was detectable WHV DNA in the livers, either at explant culture or tissue extract. Most of those WHV DNA-positive liver extracts, which were examined by Southern blot, showed integration of WHV. However, WHV DNA replicative forms without integration were demonstrated in livers of two litters from late gestation. Woodchuck hepatitis surface antigen was detected in the sera of two other fetal litters from the late gestation period. WHV DNA was demonstrated in sera of three litters at different stages of ontogeny.     

Intrafamilial transmission of hepatitis C virus

HCV infection is a major public health problem worldwide. Several studies reported that HCV infection might cluster in families or households. Horizontal intrafamilial transmission of the virus has been demonstrated previously. Whether horizontal transmission makes any significant contribution to the global burden of HCV infection is still controversial and data about epidemiology and routes of transmission are uncertain. The certain diagnosis of horizontal intrafamilial transmission of HCV is based on the simultaneous presence of specific laboratory criteria, the temporal association between intrafamilial exposure and infection and the exclusion of all the potential extrafamilial routes of transmission of the infection. This review summarizes the current knowledge of epidemiology, risk factors and molecular biology of horizontal intrafamilial transmission of HCV infection. J. Med. Virol. 85:608–614, 2013. © 2013 Wiley Periodicals, Inc.     

Perinatal transmission of hepatitis C virus infection

In industrialized countries, hepatitis C virus (HCV) is the most common cause of chronic liver disease in children. Perinatal transmission is the leading cause of infection. Perinatal transmission is confined almost always to women with detectable HCV ribonucleic acid (RNA) in the peripheral blood by the polymerase chain reaction but all children born to women with anti‐HCV antibodies should be tested for HCV. Some but not all studies found that a high concentration of serum HCV RNA is associated with a higher risk of transmission. Maternal peripheral blood mononuclear cell infection by HCV, membrane rupture of longer than 6 hr before delivery, and procedures exposing the infant to maternal blood infected with HCV during vaginal delivery are associated with an increased risk of transmission. Maternal coinfection with HCV and human immunodeficiency virus, maternal history of intravenous drug use and of HCV infection of the sexual partner of the mother predict the risk of perinatal transmission and are dependent on the peripheral blood mononuclear cell infection by HCV. Delivery by Cesarean section is not recommended in pregnant women infected with HCV. Infected mothers can breast feed safely their infants if the nipples are not damaged. A previous delivery of a child infected perinatally with HCV does not increase the risk of transmission in subsequent pregnancies. Immunogenetic factors and HCV genotypes are not related to HCV perinatal transmission. Despite an increased understanding of the risk factors involved in perinatal transmission of HCV, to date little is known about the transmission mechanisms and timing. J. Med. Virol. 81:836–843, 2009. © 2009 Wiley‐Liss, Inc.     

Intrafamilial transmission of hepatitis C virus.

Family members of hepatitis C virus (HCV)-infected hemodialysis patients had a high rate (8.1%) of HCV infection and were often infected by the same genotype of HCV as the renal patients. Renal patients who had a longer history of hemodialysis or more frequent arteriovenous shunt replacement posed a higher risk to their household contacts, especially to their primary-care providers at home.     

Prevalence of Hepatitis C virus infection in pregnant women and mother-child transmission in Ouagadougou, Burkina Faso

The aim of our study was to estimate the prevalence of Hepatitis C virus (HCV) among pregnant women and the rate of mother-child transmission. Over one month (April 26 to May 25, 2002) blood samples of 200 pregnant women who gave birth at the maternity of the university hospital and Gounguin center medical of Ouagadougou were tested for anti-HVC antibodies (Ac HCV) and anti HIV antibodies (Ac HIV). Infants born to mother tested positive for Ac HCV and their mother were tested for HCV-RNA. The prevalence of HCV (positive Ac HCV and HCV-RNA) was 2% in pregnant women (4/200). One case of mother-child transmission was found. The virus transmitted was 2a (A/C) genotype. The mother had a high titre of HCV-ARN, was co-infected by HIV and had had history of blood transfusion, excision and tattoo of the gums.     

Nosocomial transmission of hepatitis C virus in haemodialysis patients

A systematic virological follow-up of 114 haemodialysis patients treated in the same unit showed that 37, including 17 PCR positive patients, were seropositive for hepatitis C virus (HCV). Type 1b HCV was detected in 10 patients and was much more frequent in this population than in the whole population of patients treated in the hepatogastroenterology departments in southeastern France. The E1/E2 genomic region of seven type 1b HCV strains was sequenced. In four patients, a similar strain was detected in both the E1 variable region and the E2 hypervariable region (HVR1). In addition, two of these four patients were seronegative and PCR negative at the beginning of the study and had not been transfused or transplanted during this period. A phylogenetic tree was drawn which confirmed that these strains were very similar and showed that HCV was transmitted via the nosocomial pathway in this haemodialysis unit. © 1996 Wiley-Liss, Inc.     

Intrafamilial transmission of hepatitis C virus in hemodialysis patients

The prevalence of hepatitis C virus (HCV) infection in chronic hemodialysis patients ranges from 20 to 50% and these patients may serve as a reservoir of infection for their household contacts. The aim of this study was to investigate the prevalence of anti-HCV in hemodialysis patients and their families, and to evaluate possible routes of infection. One hundred eighty-six family members of 84 hemodialysis patients and 529 healthy adults were enrolled. The family members consisted of 50 spouses, 96 children, 11 parents, 29 siblings, and other relatives living together with the patients. Serum samples were collected for testing anti-HCV. Exposure to risk factors was obtained by a questionnaire and an interview. The results showed that prevalence of anti-HCV in hemodialysis patients was 44%, whereas in family members it was 5.4%, not significantly different from that of age-matched healthy adults (standardized morbidity rate = 1.51, P = 0.390). The anti-HCV rate in family members tended to increase with age, and a spouse of an infected hemodialysis patient had a higher risk of HCV infection than other family members (15% vs. 2.6%, odds ratio 6.6, P = 0.058). Except for the age factor, no difference was found between seropositive and se-ronegative family members with respect to risk factors such as blood transfusion, surgery, frequent injections, dental procedures, or acupuncture. It was concluded that, although the anti-HCV positivity of hemodialysis patients is high, the risk of HCV infection for their family members is not higher than that of the general population. Among family members, spouses of seropositive hemodialysis patients have the highest risk of HCV infection. These data imply that long-term intimate contact between spouses plays a key role in the intrafamilial transmission of HCV. © 1995 Wiley-Liss, inc.     

Intrafamilial transmission of hepatitis C virus in Japan.

To clarify the intrafamilial transmission of hepatitis C virus (HCV), the prevalence of antibody to HCV (anti-HCV) in 107 index patients with type C chronic liver disease was studied and compared with the prevalence of anti-HCV antibody in their 296 family members. Of the 85 index patients who were positive for anti-HCV, 15 (8%) of 196 of their family members were also HCV antibody positive, whereas of the 22 index patients who were anti-HCV antibody negative, none of the family members of the 100 evaluated was positive for anti-HCV antibody, a statistically significant difference between groups (P less than 0.02). No specific relative (spouse, child, parent, and sibling) was linked to HCV positivity in the index cases making it difficult to identify the route of infection that is believed to occur via the parenteral route in the home or community.     

妊娠期TORCH感染与乙型肝炎病毒感染的关系

目的了解武汉地区不同孕期孕妇TORCH感染及乙型肝炎病毒(简称乙肝)感染的情况,以及两者之间有无关联.方法 2003年7月至2004年2月来我院门诊检查的398例孕妇抽取其空腹静脉血,检测其特异性TORCH-IgM抗体和乙肝三抗.结果 TORCH感染和乙肝感染在各孕期均无显著性差异.早、中孕期TORCH感染与乙肝感染存在一定的关联.结论加强孕期TORCH感染和乙肝的监测十分重要.提示在临床进行产前检查时,应将两者同时检测.     

Sexual transmission of GB virus C/hepatitis G virus

Although it is established that infection with GB virus C (GBV-C) or hepatitis G virus (HGV) can be transmitted parenterally, the prevalence of GBV-C/HGV viremia in the general population (2–5%) is relatively high compared with other parenterally borne viruses such as hepatitis C virus. To investigate the possibility of sexual transmission of GBV-C/HGV, we determined the frequency of viremia by the polymerase chain reaction and serological reactivity to the E2 protein by ELISA in samples collected from individuals at risk for sexually transmitted diseases attending a city genitourinary medicine clinic. GBV-C/HGV viremia was detected in 27 of 87 male homosexuals (31%) and 9 of 50 prostitutes (18%), frequencies significantly greater than those in matched controls (2/63) and local blood donors (2.3%). Among nonviremic individuals, a high frequency of serological reactivity to the E2 protein of GBV-C/HGV was also observed in the risk groups (male homosexuals: 14/60; prostitutes: 11/41), although these figures are likely to be underestimates of the frequency of past infection as detectable anti-E2 reactivity may attenuate rapidly over time following resolution of infection. Infection with GBV-C/HGV was more frequent among those coinfected with human immunodeficiency virus type 1. Among male homosexuals from whom retrospective samples were available, evidence for de novo infection was found in 9 of 22 individuals over a mean sampling time of 2.9 years, predicting an annualized incidence of GBV-C/HGV infection of approximately 11% in this group. The high prevalence and incidence of GBV-C/HGV infection in these individuals and prostitutes provides strong evidence for its spread by sexual contact. Further studies are required to investigate the mechanism of its transmission and the clinical significance of acute and persistent infection in these risk groups. J. Med. Virol. 55:203–208, 1998. © 1998 Wiley-Liss, Inc.     

乙肝免疫球蛋白阻断乙肝病毒母婴垂直传播的研究

目的研究乙肝免疫球蛋白应用于孕妇为乙肝病毒携带者对阻断乙肝病毒母婴垂直传播的效果。方法A组123例，于孕28、32、36w分别注射HBIG200u，B组130例仅常规产前检查及监护。结果A组较B组新生儿出生时外周血HB—sAg阳性率显著降低P〈0．05。结论对乙肝病毒携带的孕妇晚期应用HBIG可以显著降低新生儿外周血HBSAg阳性率。     

Mother to infant transmission of hepatitis C virus infection

Eight women with chronic hepatitis C virus (HCV) infection during pregnancy gave birth to 11 children. Five of these children had elevated ALT, but only two had increased levels in more than one sample. All children tested before 6 months of age were positive for anti-HCV at most up to 7 months of age and then became negative. One child with a maximum ALT level of 8.4 mukat/l however, regained anti-HCV positivity at 12 months of age, and a liver biopsy at 21 months of age showed resolving hepatitis. Passively acquired HCV antibodies are obviously found in newborns of anti-HCV-positive mothers with chronic hepatitis. In 1 of 11 children, active anti-HCV production and concomitant liver disease suggested mother to infant transmission of hepatitis C virus infection.     

Patterns of serologic markers of hepatitis B virus infection and the risk of transmission among pregnant women in southwestern Nigeria

Hepatitis B virus (HBV) infection is a major health concern in developing countries that has a high morbidity and mortality rate. Vertical transmission of HBV from mother to child has been identified as a major factor leading to chronicity with attendant liver conditions, especially in poor socioeconomic settings. This study aims to evaluate the prevalence of serological HBV markers among pregnant women in Ibadan southwestern Nigeria and to determine the implications for perinatal HBV transmission. This study revealed the presence of varied HBV serological patterns of infection or immunity among pregnant women in Ibadan, Nigeria, and thus the risk of mother to child transmission.     

Mother-to-infant transmission occurs more frequently with GB virus C than hepatitis C virus

Summary.  A total of 107 hepatitis C virus (HCV)-infected pregnant women were screened for GB virus C (GBV-C) RNA in their sera, and 11 (10.3%) were positive. Among 11 infants born to these HCV/GBV-C co-infected mothers, GBV-C RNA was detected in 7 (63.6%) while HCV RNA was found in 1 (9.1%) within 1 year after birth: this difference was statistically significant (p = 0.023). The mothers of infected infants had significantly higher serum titers of GBV-C RNA than those of uninfected infants: 10^6.7±0.5 vs 10^4.0±1.0 copies/ml in average (p=0.001). The baby in whom HCV RNA was found was also positive for GBV-C RNA, and had an elevation in serum transaminase levels, whereas all the other GBV-C infected infants showed no evidence for hepatitis. A family study, performed on 2 of the 7 infected cases, revealed that all the elder siblings of the index infants were also GBV-C RNA-positive. Nucleotide sequence of GBV-C RNA, amplified by PCR from an NS3 region, was completely identical between the mother and the infant within each family, but varied significantly across different families. These results suggest that GBV-C is more easily transmitted from mother to infant than HCV, although hepatitis is not caused thereby. Aaccepted August 26, 1997 Received July 30, 1997     

Selective transmission of hepatitis C virus in vivo and in vitro

Summary A human plasma containing quasi-species of hepatitis C virus (HCV) was inoculated to a chimpanzee and to human lymphocytic cell lines, HPB-Ma clone 10-2, AD HPB, and Daudi, which support replication of HCV. Among six different hypervariable region (HVR) sequences detected in the inoculum, the same two were recovered both in vivo and in vitro.     

Prevalence of hepatitis B virus infection in pregnant Turkish women and their families

A total of 5,366 pregnant Turkish women were screened for hepatitis B surface antigen (HBsAg) and 225 (4.2%) of them were found to be positive. Hepatitis B e antigen (HBeAg) was detected in 6.2% of HBsAg-positive pregnant women. The overall prevalence of HBsAg and antibody to HBsAg (anti-HBs) among the spouses, previous children, mothers and first degree relatives of the HBsAg-positive pregnant women was 56%, 49%, 79% and 74% respectively. The prevalence of HBsAg is thus high in pregnant Turkish women with familial clustering of hepatitis B virus infection.