Late Hcv Clearance In Children Infected At Birth Is Not An Unfrequent Event

168 Mother-to-child transmission of hepatitis C virus (HCV) is a rare event occurring in less than 5% of pregnancies in HCV+ mothers. The evolution of these early infections is unknown, as is the rate of spontaneous clearance of the virus in infected children. We followed a cohort of 12 children infected at birth, in whom PCR-HCV was positive at least once after the first month of life, and HCV antibodies were persistently found after the first year. None was HIV+. The genotype was la(2), lb (5), and 3 (5). Clinical examination was normal in all children during follow-up. In 3 children PCR-HCV was found negative between the ages of 2 1/2 and 3 1/2 years and remained negative at subsequent controls with a follow-up of 1 to 3 years. The genotypes were la (2) and 3 (1). The transaminases measured in the second year of life were elevated (mean 80 IU) and returned to normal after negativation of PCR. We suggest that the elevated transaminases could be a marker of subacute evolution in these infected neonates and that clearance of the virus can occur several years after infection in this population. Further follow-up studies are necessary to evaluate the real frequency of this event and establish correlation with the viral genotype or load, and the level of transaminases. No early treatment should be proposed to these children who have a chance to recover spontaneously.