Use of polymerase chain reaction and antibody tests in the diagnosis of vertically transmitted hepatitis C virus infection

Eur J Clin Microbiol Infect Dis. 1997 Oct;16(10):711-9. doi: 10.1007/BF01709250.


Data on patterns of polymerase chain reaction (PCR) and antibody test results in infants born to hepatitis C virus (HCV)-infected mothers were systematically reviewed to aid development of optimum testing schedules and diagnostic criteria for vertically exposed infants and to facilitate early identification of infected infants. Survival and cross-sectional analyses were used to estimate the timing of initial PCR positivity and subsequent PCR negativity in infected infants, and maternal antibody loss in uninfected infants was estimated as a weighted average of individual study findings. Of 74 eligible infants with strong evidence of HCV infection, an estimated 89% (90% confidence interval, 80-95%) were first PCR positive by 3 months of age, and less than 10% had subsequent PCR negativity attributable to intermittent viraemia or resolved infection in the first 18 months of life. The negative predictive value of PCR at 3 months of age was greater than 98% at an assumed rate of 5% vertical transmission, but as low as 88% at 25% transmission. The inclusion of 22 infants, each with a single PCR-positive result, increased the estimated frequency of resolved infections but made little difference to other estimates. A minority of PCR-positive infants had periods of antibody negativity by second- or third-generation assays, and among 297 uninfected infants, maternal antibody was not detected beyond 18 months. Thus, the majority of infected infants may be persistently PCR positive from 3 months of age, and the negative predictive value of PCR at 3 months is generally high. However, poor repeatability of PCR, inadequate infant follow-up, and inclusion of postnatally infected infants limits interpretation of the pooled data. Further studies using standardised PCR methodologies are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Hepacivirus / genetics
  • Hepacivirus / immunology
  • Hepacivirus / isolation & purification*
  • Hepatitis C / diagnosis*
  • Hepatitis C / epidemiology
  • Hepatitis C / transmission*
  • Hepatitis C Antibodies / analysis
  • Humans
  • Immunity, Maternally-Acquired
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology
  • Pregnancy Complications, Infectious / virology
  • RNA, Viral / analysis
  • RNA, Viral / isolation & purification
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Survival Analysis
  • Time Factors
  • Viremia / diagnosis


  • Hepatitis C Antibodies
  • RNA, Viral