Hierarchy of baby-linked immunogenetic risk factors in vertical transmission of hepatitis C virus
Abstract number: 903_r2098
Mother-to-infant transmission of hepatitis C virus (HCV) represents the major cause of paediatric HCV infection today but the rate of vertical transmission is low (56%). Data about specific predictors of HCV transmission are conflicting. Although the hypothesis regarding the role of host defences is highly intriguing, immunogenetic influence has been poorly investigated. All existing studies on associations between HCV and genetic markers have been done in adults and are mainly confined to HLA-class II serological polymorphisms.
Among 290 parities of HCV-RNA infected women, 21 babies (7%) resulted infected (HCV-RNA positive steadily positive over 20 months of age). All the 21 infected babies, 44 randomly selected uninfected ones (steadily negative for HCV-RNA during a follow-up of 2 years) and their mothers were investigated for HLA-G, -C, -DRB1, -DQA1 and -DQB1 molecular polymorphisms. Several nonimmunogenetic parameters were also considered and their contribution was weighted by multivariate analysis.
Among the different covariates, a hierarchy of susceptibility has been settled using multiple logistic regression analysis: HLA-Cw*07,-G*010401,-DRB1*0701,-DRB1*1401, maternal viral genotype 1b, male sex, first birth and breast feeding can be considered as risk factors for HCV vertical transmission. On the contrary, protection was conferred by the HLA-DQB1*06,-G*0105N,-Cw*0602,-DRB1*1104,-DRB1*1302 alleles and by formula feeding.
Our study demonstrates that the immunogenetic factors related to maternal and neonatal HLA profile may affect HCV vertical transmission and is independent from the other nonimmunogenetic parameters. The finding of babies genetically able to fight the virus so precociously could be a tangible demonstration of the feasibility of a successful vaccine."
|Session name:||XXIst ISTH Congress|
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