RESUMO
OBJECTIVE: To identify factors associated with maternal hepatitis C virus (HCV) seroprevalence and transmission of HCV as identified by qualitative HCV ribonucleic acid (RNA) in the infants of human immunodeficiency virus (HIV) infected women delivering in New York State (NYS) in 2006. STUDY DESIGN: In this retrospective cohort study of HIV-exposed infants born in NYS, leftover infant plasma from HIV diagnostic testing was de-identified and tested for HCV. If HCV antibodies were detected, a second specimen collected when the infant was >2 months old was tested for HCV qualitative RNA. Multivariate logistic regression was used to identify factors associated with HCV seropositivity. RESULTS: In a final sample of 553 live birth events with perinatal HIV exposure, 21 (3.8 %) of tested infant specimens had HCV antibodies indicative of maternal HCV seropositivity. Maternal age at delivery of >35 years, Hispanic ethnicity, white race and injection drug use (IDU) were significantly associated with HCV seropositivity in multivariate analysis. No cases of HCV vertical transmission were identified among HCV exposed infant specimens. CONCLUSIONS: This statewide population-based study of HIV-infected childbearing women shows HCV seroprevalence of 3.8 %. Maternal age of >35 years and IDU are the strongest predictors of HCV seropositivity. Although no viral transmission was documented, more comprehensive longitudinal testing would be required to conclude that HCV transmission did not occur.
Assuntos
Infecções por HIV/complicações , Hepacivirus/imunologia , Anticorpos Anti-Hepatite C/sangue , Hepatite C/epidemiologia , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por HIV/transmissão , Infecções por HIV/virologia , Hepatite C/sangue , Hepatite C/virologia , Humanos , Lactente , Idade Materna , Análise Multivariada , New York/epidemiologia , Vigilância da População , Gravidez , Complicações Infecciosas na Gravidez/virologia , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto JovemRESUMO
Platelets appear to be pathogenetic determinants in the development of lethal Forssman shock, which was provoked in guinea pigs by an intravenous injection of rabbit antiserum to sheep erythrocyte stromata. Within moments, circulating platelets (prelabeled with (14)C-serotonin) were removed from the blood stream and impacted in the lungs, where they liberated (14)C into the tissues. When animals were depleted of platelets prior to the production of shock, they survived for prolonged periods of time or were protected against death. Pretreatment with antiinflammatory compounds capable of inhibiting platelet aggregation and release phenomena had a similar protective influence. It would appear, therefore, that Forssman shock is a convenient and accessible model for investigating the mechanisms whereby platelets mediate immune vascular damage.
