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Mother-to-infant transmission of hepatitis C virus
90
Citations from the Literature
referral center for infertility and endoscopic surgery. Patients: All women with deep endometriosis (n = 136) were selected from a consecutive series of 1,252 laparoscopies for infertility, pain, or both. Interventions and Main Outcome Measurements: Deep endometriosis was excised by CO, laser and the depth of infiltration and the pelvic area measured. As part of an ongoing study, most lesions were photographed. Results: Deep endometriosis is suggested to contain three subgroups. Type I is conical shaped and suggested to be formed by intiltration. Type II is deeply located and covered by extensive adhesions and probably formed by retraction. Type III is a spherical nodule with its largest dimension under the peritoneum. Types I, II, and III are found in 4.1%, 0.8%, and 0.9% of women with infertility (n = 759) and in 10.4%, 3.2%, and 3.2% of women with pelvic pain (n = 374). Types I, II, and III are most frequently found in the revised American Fertility Society classes II, III to IV, and I, respectively. Conclusions: Three subtypes of deep endometriosis can be distinguished. Type III, which is a spherical nodule located in the recta vaginal septum is the most severe and largest lesion. This is, however, easily missed clinically because these lesions are generally scored as revised American Fertility Society class I. Depot leuprolide versus danazol in treatment of women with symptomatic endometriosis. I. Effkacy results
Wheeler J.M.; Knittle J.D.; Miller J.D. USA AM J OBSTET GYNECOL 1992 167/S (1367-1371) Objective: We aimed to assess the efficacy of depot leuprolide versus danazol in the treatment of endometriosis. Study design: A double-blind randomized trial of 270 patients from 22 centers compared the pretreatment and posttreatment laparoscopic extent of endometriosis. Pretreatment and posttreatment endometriosis symptoms and signs were assessed with standardized methods. Results: When compared with danazol, leuprolide depot caused a more rapid and profound suppression of estradiol. Leuprolide depot and danazol were similarly efficacious in decreasing the extent of endometriosis, as well as the pain and tenderness associated with endometriosis. Conclusion: Depot leuprolide is an effective alternative to danazol in decreasing the extent of endometriosis and endometriosisrelated pain.
VIRUS INFECTIOUS
DISEASES
Mother-to-infant transmission of hepatitis C virus
Wejstal R.; Wide11 A.; Mansson A.-S.; Hermodsson S.; Norkrans G. SWE ANN INTERN MED 1992 117111(887-890) Objective: To describe the rate of perinatal transmission of hepatitis C virus (HCV). Design: Follow-up study of newborn children of mothers with chronic HCV infection. Setting: A university hospital in Sweden. Participants: Fourteen women with chronic HCV infection and their 21 newly born children. Main Outcome Measures: Detection of HCV RNA in serum by the polymerase chain reaction and detection of anti-HCV antibody by second generation assays. Results: All mothers were
Int J Gynecol Obstet 42
found to be positive for anti-HCV antibody both by secondgeneration enzyme-linked immunosorbent assay (ELISA) and by second-generation recombinant immunoblot assay (RIBA2); all also had detectable serum HCV RNA. Two children had long-lasting alanine aminotransferase (ALT) elevations, and one of them became HCV RNA positive. None of the other children developed biochemical hepatitis. However, two additional children had temporary virernia. Only the child with biochemical and biopsy-proven hepatitis and detectable HCV RNA in multiple blood samples actively produced anti-HCV antibody. Conclusions: Mother-to-infant transmission of HCV infection from chronically infected women without human immunodeficiency virus (HIV) infection seems to be uncommon. Failure to detect vertical transmission of hepatitis C virus
Reinus J.F.; Leikin E.L.; Alter H.J.; Cheung L.; Shindo M.; Jett B.; Piazza S.; Shih J.W.-K. USA ANN INTERN MED 1992 117/l 1 (881-886) Objective: To search for transmission of hepatitis C virus (HCV) from infected mothers to their infants. Design: Prospective clinical, serologic, and molecular biologic follow-up (at least 3 months) of the infants of mothers with anti-HCV antibody. Setting: A county hospital providing primary and referral care in high-risk obstetrics (perinatology). Patients: Twenty-three mothers with anti-HCV antibody and their 24 infants. Methods: An enzyme-linked immunosorbent assay (EIA) and a four-antigen recombinant immunoblot assay (RIBA) were used to test for anti-HCV antibody; serum HCV RNA was measured in two independent laboratories by reverse transcription and polymerase chain reaction (PCR) using nested primers in the 5’noncoding region. Infant samples were tested for HCV RNA by PCR at delivery and after 3 to 6 months of follow-up. Each sample was tested at least four times in two independent laboratories. Results: Twenty-nine of 648 mothers (4.5%; 95% CI, 3.0% to 6.4%) had anti-HCV antibody; these women had 30 babies. Twenty-three mothers and their 24 babies were followed at least 3 months (mean follow-up, 52 weeks). Of the 23 mothers, 21 (91%; CI, 72 to 99%) had a reactive RIBA; one woman had an indeterminate RIBA and was positive for HCV RNA by PCR. In 16 of 23 mothers (70%; CI, 47 to 87%), PCR yielded a positive result in both laboratories. The mean maternal alanine aminotransferase (ALT) level was 1.6 times the normal value. All the babies had anti-HCV antibody in cord-blood samples, but antibody disappeared or diminished in strength in interval samples, and no infant had evidence of active production of anti-HCV antibody. Only 1 of 24 (4%; CI, 0.1 to 21%) cord-blood samples was HCV RNA positive, and none of 24 (0%; CI, 0 to 14%) follow-up samples was positive for HCV RNA by PCR in either laboratory. Four mothers and one baby had antibody to HIV. Conclusions: Infant anti-HCV antibody is most likely acquired passively in utero, and vertical transmission of HCV is uncommon. Placental phagocytic cells infected with herpes simplex type 2 and echovirus type 19: Virological and ultrastructural aspects
Oliveira L.H.S.; Fonseca M.E.F.; De Bonis M. BRA
Citations from the Literature
referral center for infertility and endoscopic surgery. Patients: All women with deep endometriosis (n = 136) were selected from a consecutive series of 1,252 laparoscopies for infertility, pain, or both. Interventions and Main Outcome Measurements: Deep endometriosis was excised by CO, laser and the depth of infiltration and the pelvic area measured. As part of an ongoing study, most lesions were photographed. Results: Deep endometriosis is suggested to contain three subgroups. Type I is conical shaped and suggested to be formed by intiltration. Type II is deeply located and covered by extensive adhesions and probably formed by retraction. Type III is a spherical nodule with its largest dimension under the peritoneum. Types I, II, and III are found in 4.1%, 0.8%, and 0.9% of women with infertility (n = 759) and in 10.4%, 3.2%, and 3.2% of women with pelvic pain (n = 374). Types I, II, and III are most frequently found in the revised American Fertility Society classes II, III to IV, and I, respectively. Conclusions: Three subtypes of deep endometriosis can be distinguished. Type III, which is a spherical nodule located in the recta vaginal septum is the most severe and largest lesion. This is, however, easily missed clinically because these lesions are generally scored as revised American Fertility Society class I. Depot leuprolide versus danazol in treatment of women with symptomatic endometriosis. I. Effkacy results
Wheeler J.M.; Knittle J.D.; Miller J.D. USA AM J OBSTET GYNECOL 1992 167/S (1367-1371) Objective: We aimed to assess the efficacy of depot leuprolide versus danazol in the treatment of endometriosis. Study design: A double-blind randomized trial of 270 patients from 22 centers compared the pretreatment and posttreatment laparoscopic extent of endometriosis. Pretreatment and posttreatment endometriosis symptoms and signs were assessed with standardized methods. Results: When compared with danazol, leuprolide depot caused a more rapid and profound suppression of estradiol. Leuprolide depot and danazol were similarly efficacious in decreasing the extent of endometriosis, as well as the pain and tenderness associated with endometriosis. Conclusion: Depot leuprolide is an effective alternative to danazol in decreasing the extent of endometriosis and endometriosisrelated pain.
VIRUS INFECTIOUS
DISEASES
Mother-to-infant transmission of hepatitis C virus
Wejstal R.; Wide11 A.; Mansson A.-S.; Hermodsson S.; Norkrans G. SWE ANN INTERN MED 1992 117111(887-890) Objective: To describe the rate of perinatal transmission of hepatitis C virus (HCV). Design: Follow-up study of newborn children of mothers with chronic HCV infection. Setting: A university hospital in Sweden. Participants: Fourteen women with chronic HCV infection and their 21 newly born children. Main Outcome Measures: Detection of HCV RNA in serum by the polymerase chain reaction and detection of anti-HCV antibody by second generation assays. Results: All mothers were
Int J Gynecol Obstet 42
found to be positive for anti-HCV antibody both by secondgeneration enzyme-linked immunosorbent assay (ELISA) and by second-generation recombinant immunoblot assay (RIBA2); all also had detectable serum HCV RNA. Two children had long-lasting alanine aminotransferase (ALT) elevations, and one of them became HCV RNA positive. None of the other children developed biochemical hepatitis. However, two additional children had temporary virernia. Only the child with biochemical and biopsy-proven hepatitis and detectable HCV RNA in multiple blood samples actively produced anti-HCV antibody. Conclusions: Mother-to-infant transmission of HCV infection from chronically infected women without human immunodeficiency virus (HIV) infection seems to be uncommon. Failure to detect vertical transmission of hepatitis C virus
Reinus J.F.; Leikin E.L.; Alter H.J.; Cheung L.; Shindo M.; Jett B.; Piazza S.; Shih J.W.-K. USA ANN INTERN MED 1992 117/l 1 (881-886) Objective: To search for transmission of hepatitis C virus (HCV) from infected mothers to their infants. Design: Prospective clinical, serologic, and molecular biologic follow-up (at least 3 months) of the infants of mothers with anti-HCV antibody. Setting: A county hospital providing primary and referral care in high-risk obstetrics (perinatology). Patients: Twenty-three mothers with anti-HCV antibody and their 24 infants. Methods: An enzyme-linked immunosorbent assay (EIA) and a four-antigen recombinant immunoblot assay (RIBA) were used to test for anti-HCV antibody; serum HCV RNA was measured in two independent laboratories by reverse transcription and polymerase chain reaction (PCR) using nested primers in the 5’noncoding region. Infant samples were tested for HCV RNA by PCR at delivery and after 3 to 6 months of follow-up. Each sample was tested at least four times in two independent laboratories. Results: Twenty-nine of 648 mothers (4.5%; 95% CI, 3.0% to 6.4%) had anti-HCV antibody; these women had 30 babies. Twenty-three mothers and their 24 babies were followed at least 3 months (mean follow-up, 52 weeks). Of the 23 mothers, 21 (91%; CI, 72 to 99%) had a reactive RIBA; one woman had an indeterminate RIBA and was positive for HCV RNA by PCR. In 16 of 23 mothers (70%; CI, 47 to 87%), PCR yielded a positive result in both laboratories. The mean maternal alanine aminotransferase (ALT) level was 1.6 times the normal value. All the babies had anti-HCV antibody in cord-blood samples, but antibody disappeared or diminished in strength in interval samples, and no infant had evidence of active production of anti-HCV antibody. Only 1 of 24 (4%; CI, 0.1 to 21%) cord-blood samples was HCV RNA positive, and none of 24 (0%; CI, 0 to 14%) follow-up samples was positive for HCV RNA by PCR in either laboratory. Four mothers and one baby had antibody to HIV. Conclusions: Infant anti-HCV antibody is most likely acquired passively in utero, and vertical transmission of HCV is uncommon. Placental phagocytic cells infected with herpes simplex type 2 and echovirus type 19: Virological and ultrastructural aspects
Oliveira L.H.S.; Fonseca M.E.F.; De Bonis M. BRA