Neonatal Exposure to Hepatitis C Virus Antigens in Uninfected Children Born to Infected Mothers.

Objectives: Vertical transmission of hepatitis C virus (HCV) infection is uncommon and occurs in around 5% of births from HCV infected mothers. The reason for the low transmission rate is unclear. We aimed to investigate if there is evidence of HCV exposure also in the non-infected children born to HCV infected mothers by the presence of a detectable immune response. Methods: Serum and peripheral blood mononuclear cells from 9 HCV vertically infected children, 32 uninfected children born to HCV infected mothers, and 15 HCV chronically infected mothers, were analyzed. HCV-RNA negative adults and children were used as controls. HCV specific T cell responses were analyzed by interferon gamma (IFN-[gamma]) using an enzyme-linked immunospot (ELISpot) assay and 3H-thymidine incorporation assay. HCV antibodies were also analyzed. Results: An HCV specific T cell response was detected in 73% (11/15) of the HCV infected mothers, 67% (6/9) of the vertically infected children, 56% (18/32) of the exposed but uninfected children and in 10% and 20% of the control groups, respectively. The two groups of HCV exposed children both had a significantly higher proportion of HCV specific T cell responders compared to pediatric controls (p = 0.01 and p = 0.02). Conclusion: HCV specific immune responses were more common in children born to HCV infected mothers, regardless of the presence of HCV RNA. We conclude that non-infected children born to HCV infected mothers may have been exposed to HCV antigens. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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