Detection of hepatitis C virus RNA (HCV RNA) in amniotic fluid:: a prospective study

Background/Aims: Mother-to-infant transmission of hepatitis C virus (HCV) has been reported, but the transmission route is unknown, The aim of our study was to detect HCV RNA in amniotic fluid of pregnant women seropositive for HCV. Methods: Twenty-two HCV seropositive women were included in the study (median age: 39 years). An amniocentesis was performed in all patients during the 4th month of pregnancy. Sixteen women also tested positive for HCV RNA in serum. The range of HCV RNA titers was 0.3 to 15.1 x 10(6) Eq/ml (Quantiplex HCV RNA 2.0 Assay Chiron Diagnostics). Of these 16 viremic patients, four had an anterior placenta, ten had a posterior placenta and the position of the placenta,vas not determined in two cases. PCR (Amplicor HCV, Roche Diagnostics) was used to detect HCV RNA in the amniotic fluid. We also studied 11 HCV seronegative women as a control group, Results: In the viremic group (n=16), HCV RNA was detected once in amniotic fluid. The positive specimen was collected from a patient with atl HCV RNA serum value equal to 1.1 x 10(6) Eq/ml. The placenta was in an anterior position. A PCR inhibitor was detected in one case. No HCV RNA tvas detected in the amniotic fluid of sis seropositive non-viremic patients, nor in the control group. Serum HCV RNA was negative in the ten children tested, The woman whose amniotic fluid contained HCV RNA was the mother of one of them. Conclusions: HCV RNA detection in amniotic fluid is rarely positive. The anterior position of the placenta ill the only positive detection cannot rule out contamination of the amniotic fluid during the transplacental amniocentesis.