ABSTRACT
BACKGROUND: Because GB virus type C(GBV-C)/HGV (GBV-C/HGV) is blood-borne and sexually transmitted, persons at risk of infection with such viruses have a high prevalence of GBV-C/HGV markers. However, adults with no apparent risk factors, such as blood donors, frequently are positive for GBV-C/HGV markers. Mother-to-infant transmission could explain this high prevalence, but it has been studied only through small series of GBV-C/HGV-infected mothers co-infected with HCV or HIV. STUDY DESIGN AND METHODS: To determine the rate of mother-to-infant transmission of GBV-C/HGV RNA in women who are HCV- or HIV-negative, a prospective study was performed in a cohort of 288 mothers screened for viral RNA and in the infants born to GBV-C/HGV-infected mothers. RESULTS: Thirteen mothers (4.5%) were found positive for GBV-C/HGV RNA. Of the infants in whom at least one blood sample was collected between the third and the ninth months of life, 89 percent were positive for viral RNA. The majority of these newborns were negative for GBV-C/HGV RNA at birth and positive after the third month. The viral RNA titers of infants born to GBV-C/HGV-infected mothers appeared as elevated as those of their mothers. All the GBV-C/HGV-infected infants remained positive for viral RNA during the entire study period. No clinical events possibly linked to a primary GBV-C/HGV infection were reported in infants. Serum ALT level and blood count remained within normal values throughout the follow-up of all GBV-C/HGV-infected infants. CONCLUSION: The frequency of mother-to-infant GBV-C/HGV transmission is elevated and could explain the high prevalence of GBV-C/HGV markers (viral RNA and E2 antibody) in adults at low risk for blood-borne or sexually transmitted viruses, such as blood donors.
Subject(s)
Blood Donors , Flaviviridae , Hepatitis, Viral, Human/transmission , Adult , Female , Hepatitis, Viral, Human/blood , Humans , Infectious Disease Transmission, Vertical , Viral Load/statistics & numerical dataABSTRACT
PURPOSE: The necessity of saving blood products has established the practice of exchange transfusion (ET) with reconstituted blood in newborns. The aim of this retrospective study was to evaluate the indications and the practice of this technique at the Perinatal Hemobiology Centre (Paris, France). METHODS: The records of intervention allowed us to review the etiologic categories for neonates having undergone exchange transfusion with reconstituted blood, the dosages used (bilirubin, hemoglobin), and the other main parameters of ET. RESULTS: Sixty ETs were performed in 48 newborns between the 1st July 1996 and the 1st July 1998. Twenty-seven with Rh hemolytic disease had 39 ETs (19 for hyperbilirubinemia, 12 for anemia, and eight for both), whereas ten out of 12 repeated ETs were indicated for hyperbilirubinemia (six of these cases were in newborns weighing > or = 2500 g and after a volume exchange < or = 1 blood mass [range 0.72-1.0] at the last ET). Twenty-one cases showed other diseases: six of them had anemia, nine had hyperbilirubinemia, and seven showed disseminated coagulopathy. The tolerance of ET was poor in 24% infants in this group. CONCLUSIONS: The volume of 1.3 blood mass for ET is sufficient for the majority of cases with hyperbilirubinemia, allowing transfusional savings in comparison with the previous recommendation of two blood volumes. Exact labeling of the content of units of packed red cells and plasma is essential to fulfill the volume and hematocrit requirements in every case.
