Download PDF
Kinder- und Jugendmedizin 2014; 14(02): 93-100
DOI: 10.1055/s-0038-1629381
Infektiologie
Schattauer GmbH

Konnatale Virus-Hepatitis-Infektionen

Congenital infections due to hepatitis viruses
D. Lenz
1   Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg
,
P. Henneke
1   Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg
2   Centrum für Chronische Immundefizienz, Universitätsklinikum Freiburg
› Author Affiliations
Further Information

Publication History

Eingereicht am:14 November 2013

angenommen am:04 December 2013

Publication Date:
31 January 2018 (online)

    Permissions and Reprints

Zusammenfassung

Konnatale Infektionen durch Hepatitis-Viren sind weltweit weiterhin wichtige Ursachen für terminales Leberversagen und Lebertransplantationen. Während konnatale Infektionen durch Hepatitis-B-Virus (HBV) bei in Deutschland geborenen Kindern durch Schwangerschaftsscreening und flächendeckende Impfung sehr selten geworden sind, bleiben Hepatitis-C-Virus (HCV)-Infektionen in vielen Fällen unbemerkt.

Die Identifikation von Frauen mit besonderem Risiko für eine Hepatitis-B-Primärinfektion während der Schwangerschaft bleibt eine besondere Herausforderung. Ohne Behandlung sind Transmissions- und Chronifzierungsraten sehr hoch. Gleichzeitig ist aber die perinatale Prophylaxe durch Simultanimpfung sehr effektiv. Hat sich eine chronische HBV-Infektion beim Kind etabliert, so sind die zur Verfügung stehenden Behandlungsmöglichkeiten weiterhin unbefriedigend. Im Gegensatz zur HBV-Infektion bestehen bei Kenntnis einer HCV-Infektion bei Schwangeren zunächst keine Möglichkeiten zur Verringerung der Transmission auf das Kind (Transmissionsrate 5–10 %). Die Kenntnis einer HCV-Infektion des Kindes ist aber wichtig, da je nach Genotyp wirksame bis sehr wirksame Therapieoptionen zur Verfügung stehen.

Summary

Congenital infections by hepatitis viruses are important causes of terminal liver failure and liver transplantation worldwide. While congenital infection by hepatitis B virus (HBV) in children born in Germany have become very rare due to pregnancy screening and vaccination programs, hepatitis C Virus (HCV) infections often stay unnoticed.

The identification of women with a particular risk for a primary hepatitis B infection during pregnancy remains a particular challenge. Rates of transmission and chronification are very high, but at the same time perinatal prophylaxis by simultaneous vaccination is very effective. Once a chronic HBV infection is established in a child, the available treatment options are still unsatisfactory. Contrary to HBV infections, in HCV infection in a pregnant woman effective measures to reduce transmission to the child are not available (transmission rate 5–10 %). Nevertheless, the knowledge of a HCV infection in the child is important because effective or very effective treatment options are available depending on the genotype.

Schlüsselwörter

Vertikale Transmission - konnatale Infektion - Hepatitis B - Hepatitis C

Keywords

Vertical transmission - congenital infection - hepatitis B - hepatitis C
 

  • Literatur

  • 1 Alter MJ, Margolis HS, Krawczynski K. et al. The natural history of community-acquired hepatitis C in the United States. The Sentinel Counties Chronic non-A, non-B Hepatitis Study Team. N Engl J Med 1992; 327: 1899-1905.
    CrossrefGoogle Scholar
  • 2 American Academy of Pediatrics CoID Hepatitis C. In: Pickering LK. (ed). Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed.. Elk Grove Village, IL: American Academy of Pediatrics; 2012: 489-99.
    Google Scholar
  • 3 AWMF AK-P Infektionsprävention unter der Entbindung. HygMed 2012; 37: 134ff
    Google Scholar
  • 4 Belloni C, Chirico G, Pistorio A. et al. Immunogenicity of hepatitis B vaccine in term and preterm infants. Acta Paediatr 1998; 87: 336-338.
    CrossrefPubMedGoogle Scholar
  • 5 Bonino F, Marcellin P, Lau GK. et al. Predicting response to peginterferon alpha-2a, lamivudine and the two combined for HBeAg-negative chronic hepatitis B. Gut 2007; 56: 699-705.
    CrossrefGoogle Scholar
  • 6 Burdelski M, Wirth S, Laufs R. Viral hepatitis in children and adolescence. Z Gastroenterol 2004; 42: 731-733.
    Article in Thieme ConnectGoogle Scholar
  • 7 Chang MH, Sung JL, Lee CY. et al. Factors affecting clearance of hepatitis B e antigen in hepatitis B surface antigen carrier children. J Pediatr 1989; 115: 385-390.
    CrossrefGoogle Scholar
  • 8 Cornberg M, Protzer U, Dollinger MM. et al. Prophylaxis, diagnosis and therapy of hepatitis B virus (HBV) infection: the German guidelines for the management of HBV infection. Z Gastroenterol 2007; 45: 1281-1328.
    Article in Thieme ConnectGoogle Scholar
  • 9 Daudi N, Shouval D, Stein-Zamir C, Ackerman Z. Breastmilk hepatitis A virus RNA in nursing mothers with acute hepatitis A virus infection. Breastfeed Med 2012; 7: 313-315.
    CrossrefGoogle Scholar
  • 10 Deutsche Gesellschaft für Pädiatritsche Infektiologie (Hrsg) DGPI Handbuch: Infektionen bei Kindern und Jugendlichen. Stuttgart, New York: Thieme Verlag; 2013
    Google Scholar
  • 11 European Paediatric Hepatitis C Virus Network Three broad modalities in the natural history of vertically acquired hepatitis C virus infection. Clin Infect Dis 2005; 41: 45-51.
    CrossrefPubMedGoogle Scholar
  • 12 Farmand S, Wirth S, Loffler H. et al. Spontaneous clearance of hepatitis C virus in vertically infected children. Eur J Pediatr 2012; 171: 253-258.
    CrossrefPubMedGoogle Scholar
  • 13 Hamid SS, Jafri SM, Khan H. et al. Fulminant hepatic failure in pregnant women: acute fatty liver or acute viral hepatitis?. J Hepatol 1996; 25: 20-27.
    CrossrefGoogle Scholar
  • 14 Hussaini SH, Skidmore SJ, Richardson P. et al. Severe hepatitis E infection during pregnancy. J Viral Hepat 1997; 4: 51-54.
    Google Scholar
  • 15 Jonas MM, Hepatitis C. virus infection in children. Edwards MS, Rand EB, Hoppin AG. (eds). Waltham, MA: UpToDate; 2013
    Google Scholar
  • 16 Khuroo MS, Kamili S, Jameel S. Vertical transmission of hepatitis E virus. Lancet 1995; 345: 1025-1026.
    CrossrefGoogle Scholar
  • 17 Khuroo MS, Kamili S. Clinical course and duration of viremia in vertically transmitted hepatitis E virus (HEV) infection in babies born to HEV-infected mothers. J Viral Hepat 2009; 16: 519-523.
    CrossrefGoogle Scholar
  • 18 Komatsu H, Inui A, Sogo T. et al. Tears from children with chronic hepatitis B virus (HBV) infection are infectious vehicles of HBV transmission: experimental transmission of HBV by tears, using mice with chimeric human livers. J Infect Dis 2012; 206: 478-485.
    CrossrefGoogle Scholar
  • 19 Losonsky GA, Wasserman SS, Stephens I. et al. Hepatitis B vaccination of premature infants: a reassessment of current recommendations for delayed immunization. Pediatrics 1999; 103: E14
    CrossrefGoogle Scholar
  • 20 Motte A, Blanc J, Minodier P, Colson P. Acute hepatitis A in a pregnant woman at delivery. Int J Infect Dis 2009; 13: e49-51.
    CrossrefGoogle Scholar
  • 21 Nanda SK, Yalcinkaya K, Panigrahi AK. et al. Etiological role of hepatitis E virus in sporadic fulminant hepatitis. J Med Virol 1994; 42: 133-137.
    CrossrefGoogle Scholar
  • 22 O’Donovan DJ. Hepatitis viruses and the newborn: Clinical manifestations and treatment. Weisman LE, Kaplan SL, Rand EB. (eds). Waltham, MA: UpToDate; 2013
    Google Scholar
  • 23 Ohto H, Terazawa S, Sasaki N. et al. Transmission of hepatitis C virus from mothers to infants. The Vertical Transmission of Hepatitis C Virus Collaborative Study Group. N Engl J Med 1994; 330: 744-750.
    CrossrefGoogle Scholar
  • 24 Palomba E, Manzini P, Fiammengo P. et al. Natural history of perinatal hepatitis C virus infection. Clin Infect Dis 1996; 23: 47-50.
    CrossrefGoogle Scholar
  • 25 Pasetti G, Calzetti C, Degli Antoni A. et al. Clinical features of hepatitis delta virus infection in a northern Italian area. Infection 1988; 16: 345-348.
    CrossrefGoogle Scholar
  • 26 Patra S, Kumar A, Trivedi SS. et al. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med 2007; 147: 28-33.
    CrossrefGoogle Scholar
  • 27 Renge RL, Dani VS, Chitambar SD, Arankalle VA. Vertical transmission of hepatitis A. Indian J Pediatr 2002; 69: 535-536.
    CrossrefGoogle Scholar
  • 28 Rosenblum LS, Villarino ME, Nainan OV. et al. Hepatitis A outbreak in a neonatal intensive care unit: risk factors for transmission and evidence of prolonged viral excretion among preterm infants. J Infect Dis 1991; 164: 476-482.
    CrossrefGoogle Scholar
  • 29 Ruiz-Extremera A, Salmeron J, Torres C. et al. Follow-up of transmission of hepatitis C to babies of human immunodeficiency virus-negative women: the role of breast-feeding in transmission. Pediatr Infect Dis J 2000; 19: 511-516.
    CrossrefGoogle Scholar
  • 30 Tai AW, Chung RT. Studies of telaprevir and boceprevir in the treatment of chronic hepatitis C Virus genotype 1. Bisceglie AMD, Bloom A. (eds) Waltham, MA: UpToDate; 2013
    Google Scholar
  • 31 Thaler MM, Park CK, Landers DV. et al. Vertical transmission of hepatitis C virus. Lancet 1991; 338: 17-18.
    CrossrefGoogle Scholar
  • 32 Thomas SL, Newell ML, Peckham CS. et al. A review of hepatitis C virus (HCV) vertical transmission: risks of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection. Int J Epidemiol 1998; 27: 108-117.
    CrossrefGoogle Scholar
  • 33 Tong MJ, Thursby MW, Lin JH. et al. Studies on the maternal-infant transmission of the hepatitis B virus and HBV infection within families. Prog Med Virol 1981; 27: 137-147.
    Google Scholar
  • 34 Tovo PA, Pembrey LJ, Newell ML. Persistence rate and progression of vertically acquired hepatitis C infection. European Paediatric Hepatitis C Virus Infection. J Infect Dis 2000; 181: 419-424.
    CrossrefGoogle Scholar
  • 35 Watson JC, Fleming DW, Borella A. et al. Vertical transmission of hepatitis A resulting in an outbreak in a neonatal intensive care unit. J Infect Dis 1993; 167: 567-571.
    CrossrefGoogle Scholar
  • 36 Wen WH, Chang MH, Hsu HY. et al. The development of hepatocellular carcinoma among prospectively followed children with chronic hepatitis B virus infection. J Pediatr 2004; 144: 397-399.
    CrossrefGoogle Scholar
  • 37 Wirth S, Pieper-Boustani H, Lang T. et al. Peginterferon alfa-2b plus ribavirin treatment in children and adolescents with chronic hepatitis C. Hepatology 2005; 41: 1013-1018.
    CrossrefGoogle Scholar
  • 38 Zanetti AR, Tanzi E, Paccagnini S. et al. Mother-to-infant transmission of hepatitis C virus. Lombardy Study Group on Vertical HCV Transmission. Lancet 1995; 345: 289-291.
    CrossrefGoogle Scholar
  • 39 Zhang RL, Zeng JS, Zhang HZ. Survey of 34 pregnant women with hepatitis A and their neonates. Chin Med J (Engl) 1990; 103: 552-555.
    Google Scholar