Vertical transmission of HCV infection: prospective study in infants born to HIV-1 seronegative women.

OBJECTIVE: We performed a long-term prospective trial in infants born to HCV positive but HIV-1 negative women, with the aim of evaluating vertical transmission of HCV and correlated risks factors. METHODS: From April 1996 to May 2002, 50 women in the 3rd trimester of pregnancy or close to delivery we enrolled in the study. Anti-HCV antibodies were detected by 2nd and 3rd generation ELISA tests (ABBOTT HCV 2nd EIA generation and MEIA Abbot Labs, IL) . Reactivity was confirmed by a commercial immunoblot (Abbott Matrix HCV 2.0) ad HCV-RNA was detected by a nested-PCR technique. Infants were prospectively followed by clinical and laboratory tests (ALT levels, anti HCV Ab and HCV RNA) every 3 or 6 months for 16 to-80 months (average: 28.5 months). RESULTS: Twenty-eight of 50 women (56%) were found positive for HCV-RNA at delivery, and in 17/50 no risk factors for HCV infection were identified. Vertical transmission of HCV was detected in 3/28 infants born to viremic mothers (10.7%), while none of the 22 non-viremic mothers transmitted the infection to their children. Prolonged HCV seronegativity was documented in one of the three infected infants. During follow-up three other infants presented a single positive PCR value; one infant resulted HCV positive at 51 months of age. All infants were anti-HCV positive at delivery due to passive acquisition of antibodies, and in the 44 uninfected infants the antibody titres decreased progressively and became negative at various intervals (3-18 months). CONCLUSION: The overall vertical transmission rate was 6% but the risk of transmission of HCV infection is limited to women that are HCV RNA positive at delivery. This study shows that vertical transmission of HCV infection possibly occurs in immunocompetent infants with no HCV antibodies detected in the serum. Furthermore, we emphasise that a prolonged follow-up is absolutely mandatory in order ot establish the occurrence of active infection.

[Perinatal infections of B19 Parvoviruses] / Infezione perinatale da Parvovirus B19 e destino del neonato.

This study is aimed at detecting perinatal infections of Parvovirus B19 (PV B19). The authors have analyzed specific antibodies (IgM and IgG) in the cord serum of 647 babies, born consecutively at the St. Eugenio Hospital in Rome. 156 of them (24%) were positive to IgG. The analysis of viral genome by PCR methods showed three positive subjects (2%). The three newborn babies did not develop any pathologies during a two-year follow-up and PCR became negative within the first 6 months. Data show that a mass pregnancy test is not useful for PV B19 detection, and that specific antibody analysis should be limited to pregnancies at risk. However healthy the infected patients may appear at birth, though, it is advisable to have them monitored for at least one year so as to avoid the risk of chronic infections.

[Etiology of rare diseases caused by novel viral agents: a review of the most recent literature]. / Eziologia di malattie rare da nuovi agenti virali: una indagine della letteratura più recente.

The authors describe the viral pathologies that have become rare in Italy and in the rest of the western world; they also analyze some novel agents mainly imported from the tropical and Asian Countries. For some of the microorganisms, they describe the various zones at risk, ways of transmission, clinical case, recent lab methods and preventive measures.