Hierarchy of baby-linked immunogenetic risk factors in the vertical trasnmission of hepatitis C virus

Mother-to-infant trasmission of Hepatitis C Virus (HCV) represents the major cause of pediatric HCV infection today. Immonogenetic influence has been poorly investigated and mainly confined to HLA-class II serological polymorphisms. Among 290 parities, 135 from Pavia and 155 from Bergamo, of HCV-RNA-infected Italian women, 21 babies (7.24%) were HCV-RNA positive at Birth and steadily positive over 20 months of life. All the 21 infected babies and 44 randomly selected uninfected ones, born to HCV-RNA+ mothers but steadily negative for HCV-RNA during a follow-up of 2 years, and their mothrs were investiated for HLA-G, -C, -DRB1, -DQA1 genomic polymorphisms. Among the different vocariates, HLS-Cw*07, -G*010401, -DRB1*0701, -DRB1*1401 and homozygosity for HLA-G 14 bp deletion can be considered as risk factors ofr HCV vertical transmission. On the contrary, protection was conferred by the HLA-DQB1*06, -G*0105N, -Cw*0602, DRB1*1104 and -DRB1*1302 alleles. Our initial question was: has the immunogenetic profile any role in the protection of the fetus growing in an infected milieu and. if so, is independent from the other non-immunogenetic parameters? The answer to both questions shoud be yes.