perinatal transmission of hepatitis viruses: the possible mechanisms

perinatal transmission of hepatitis viruses: the possible mechanisms

;Ho-Hsiung Lin
spermova 2004 Vol. 43 pp. 1-4
133
lin2004taiwaneseperinatal

Abstract

Hepatotropic viruses consist of hepatitis A (HAV), B (HBV), C (HCV), D (HDV), E (HEV), and possibly G (HGV/GB virus-C). HAV and HEV are transmitted mainly via the enteral route, whereas HBV, HCV, HDV and HGV are transmitted mainly via the parenteral route. No chronicity occurs following acute HAV or HEV infection, but a chronic carrier state does exist for HBV, HCV, HDV and HGV infections, especially in those infected during infancy or early childhood. Perinatal transmission of hepatitis viruses can be determined by the timing of infection and infectious routes during pregnancy, delivery and parturition. The former can be divided into prepartum (intrauterine), intrapartum and postpartum periods, while the latter can be divided into infection of germ cells, transplacental leakage of maternal blood, birth canal infection and infection through breast- feeding. Perinatal transmission of enteral hepatitis viruses (HAV and HEV) can occur during the intrapartum and postpartum periods, whereas transmission of the blood-borne hepatitis viruses (HBV, HCV and possibly HGV) mainly occurs during delivery (intrapartum). Both high-titer maternal viremia and mode of delivery are important determinants of the perinatal transmission of hepatitis viruses. Additionally, only HBV can infect germ cells and cause intrauterine infection. Elective cesarean section has the least microtransfusion from mother to fetus in various modes of delivery, and it may be used to prevent intrapartum HCV infection since immunoprophylaxis against this virus is unavailable.

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