Polymerase chain reaction as marker of infectivity in people with hepatitis CBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7130.553a (Published 14 February 1998) Cite this as: BMJ 1998;316:553
Summary vertical transmission rates may be misleading
- Sara Thomas, Research studenta,
- Andrew Hall, Reader in communicable disease epidemiologya,
- Marie-Louise Newell, Senior lecturer in epidemiologyb
- a Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
- b Department of Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EE
- c National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia
- d A W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia
Editor—We recently completed a systematic review of worldwide published and unpublished data on vertical transmission of hepatitis C virus.1 We agree with Dore et al that the probability of transmission of the virus from a mother with antibody to hepatitis C virus but who is negative for the virus by polymerase chain reaction is very low,2 although such transmissions have been documented.1 We are concerned, however, about their calculation of summary vertical transmission rates (their table 1).
Firstly, they have not included all the published studies that are eligible by their stated criteria (references available on request), including one that reported 100% transmission from mothers positive by polymerase chain reaction.3
Secondly, they have included two partially duplicated studies: most of the infants reported on by Paccagnini et al were included in the collaborative study by Zanetti et al (A Zanetti, unpublished communication).
Thirdly, we think it inappropriate to include in these calculations the two large retrospective studies of mothers infected from contaminated …