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Die vertikale Übertragung des Hepatitis-C-Virus von infizierten Müttern auf ihre Kinder

Das Risiko der HCV-Übertragung durch Muttermilch ist gering
  • S. Polywka
  • R. Laufs
Chapter

Zusammenfassung

In einer prospektiven Studie wurde die vertikale Übertragungsrate des Hepatitis-C-Virus (HCV) von Müttern, die während Schwangerschaft und Entbindung HCV-infiziert waren, auf ihre Kinder untersucht. In das Studienkollektiv wurden 90 Kinder von 85 bekannten, chronisch HCV-infizierten Müttern aufgenommen. Von neun Müttern war eine gleichzeitige Infektion mit dem HIV-1 bekannt. Die Serumproben der 90 Kinder wurden innerhalb von acht Wochen nach der Entbindung erstmals untersucht; Nachuntersuchungen erfolgten über mindestens drei Monate. Drei der 90 Kinder wurden HCV-infiziert (3,3%), nachgewiesen durch eine Anti-körperpersistenz über mindestens zwei Jahre sowie den Nachweis von HCV-RNA in der PCR. Eines der Kinder hatte leicht erhöhte Transaminasen, war aber klinisch wie die beiden anderen Kinder auch unauffällig. 54 der Kinder wurden so lange nachuntersucht, bis die mütterlichen Antikörper nicht mehr nachweisbar waren; dies war im Schnitt nach einem Jahr der Fall.

In einem zweiten Teil der Studie wurden 76 Milchproben von 73 chronisch HCV-infizierten Müttern auf HCV-RNA untersucht. Keine der Proben war in der PCR reaktiv. Von den 76 Kindern dieser Mütter war nur eines HCV-infiziert; der Verlauf spricht bei diesem Kind für eine HCV-Übertragung unter der Geburt und nicht durch das Stillen. Eine HCV-Infektion der Mutter ist also keine Kontraindikation gegen das Stillen.

Schlüsselwörter

Hepatitis-C-Virus Vertikale Übertragung Muttermilch 

Vertical transmission of the hepatitis-C-virus from infected mothers to their children

Summary

Children of mothers chronically infected with hepatitis-C-virus (HCV) during pregnancy and delivery were prospectively followed. 90 children born to 85 infected mothers were included in our study; nine of the mothers were known to be co-infected with HIV-1. These 90 children were first tested within 60 days after birth and followed for at least three months. Three of the 90 children became infected perinatally with HCV as shown by persistence of antibodies after 2 years of life and a positive result in the RT-PCR. One of these 3 children has evidence of ongoing hepatitis as shown by slightly elevated alanine aminotransferase values, but is otherwise clinically well, likewise the other 2 infected children. 54 of the 87 unin-fected children were followed until they lost maternal antibodies after an average of one year.

In another part of the study we tested 76 breast milk samples from 73 chronically HCV-infected mothers for the presence of HCV-RNA. None of the samples was positive. One of the 76 children of these mothers became HCV-infected; the course of infection in this case favours an HCV-transmission during pregnancy or delivery and not by breast feeding. These data show that maternal HCV-infection should not be a contraindication for breast feeding.

Key words

Hepatitis C virus Vertical transmission Breast milk 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • S. Polywka
    • 1
  • R. Laufs
    • 1
  1. 1.Institut für Medizinische Mikrobiologie und ImmunologieUniversitätskrankenhaus EppendorfHamburgDeutschland

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