European Journal of Clinical Microbiology and Infectious Diseases

, Volume 16, Issue 10, pp 711–719

Use of polymerase chain reaction and antibody tests in the diagnosis of vertically transmitted hepatitis C virus infection

  • S. L. Thomas
  • M. L. Newell
  • C. S. Peckham
  • A. E. Ades
  • A. J. Hall
Article

DOI: 10.1007/BF01709250

Cite this article as:
Thomas, S.L., Newell, M.L., Peckham, C.S. et al. Eur. J. Clin. Microbiol. Infect. Dis. (1997) 16: 711. doi:10.1007/BF01709250

Abstract

Data on patterns of polymerase chain reaction (PCR) and antibody test results in infants born to hepatitis C virus (HCV)-infected mothers were systematically reviewed to aid development of optimum testing schedules and diagnostic criteria for vertically exposed infants and to facilitate early identification of infected infants. Survival and cross-sectional analyses were used to estimate the timing of initial PCR positivity and subsequent PCR negativity in infected infants, and maternal antibody loss in uninfected infants was estimated as a weighted average of individual study findings. Of 74 eligible infants with strong evidence of HCV infection, an estimated 89% (90% confidence interval, 80–95%) were first PCR positive by 3 months of age, and less than 10% had subsequent PCR negativity attributable to intermittent viraemia or resolved infection in the first 18 months of life. The negative predictive value of PCR at 3 months of age was greater than 98% at an assumed rate of 5% vertical transmission, but as low as 88% at 25% transmission. The inclusion of 22 infants, each with a single PCR-positive result, increased the estimated frequency of resolved infections but made little difference to other estimates. A minority of PCR-positive infants had periods of antibody negativity by second- or third-generation assays, and among 297 uninfected infants, maternal antibody was not detected beyond 18 months. Thus, the majority of infected infants may be persistently PCR positive from 3 months of age, and the negative predictive value of PCR at 3 months is generally high. However, poor repeatability of PCR, inadequate infant follow-up, and inclusion of postnatally infected infants limits interpretation of the pooled data. Further studies using standardised PCR methodologies are needed.

Copyright information

© MMV Medizin Verlag GmbH 1997

Authors and Affiliations

  • S. L. Thomas
    • 1
    • 2
  • M. L. Newell
    • 2
  • C. S. Peckham
    • 2
  • A. E. Ades
    • 2
  • A. J. Hall
    • 1
  1. 1.Infectious Disease Epidemiology UnitLondon School of Hygiene & Tropical MedicineLondonUK
  2. 2.Department of Epidemiology & BiostatisticsInstitute of Child HealthLondonUK