Investigation of immunologic values in children vertically exposed to hepatitis C virus (HCV) infection could help explain the higher risk of infection in girls and indicate mechanisms of spontaneous viral clearance and possible long-term immunologic effects.
Prospective study of children born to HCV-infected women. Lymphocyte and neutrophil measurements were age-standardized using the LMS method (this summarizes the changing age distribution of a variable). Associations between maternal and infant characteristics and lymphocyte and neutrophil z-scores were quantified using linear regression allowing for repeated measures.
HCV-infected children, girls, and those born to HCV/human immunodeficiency virus (HIV)-coinfected women had significantly higher lymphocyte z-scores than HCV-uninfected children, boys, and children born to HCV-only-infected women, respectively. Peak absolute lymphocytes were significantly lower for infected children with evidence of viral clearance than for persistently infected children. Girls also had significantly higher neutrophil z-scores than boys but HCV-infected children had significantly lower neutrophil z-scores than uninfected children.
The gender associations are in line with those observed among children born to HIV-infected women, suggesting general gender-based differences in response to infection. Age-related standards for uninfected children could be used to assess immune function in other pediatric diseases and these results suggest that gender-specific reference values should be used at least for the first 2 years of life.
From the *Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health and Great Ormond Hospital for Children NHS Trust, University College London, London, UK; †Africa Centre for Health and Population Studies, University of KwaZulu Natal, Somkhele, South Africa; and ‡Dipartimento di Scienze Pediatriche e dell’ Adolescenza, Università degli Studi di Torino, Torino, Italy.
Accepted for publication February 22, 2008.
Lucy Pembrey was funded by a U.K. Medical Research Council Special Research Training Fellowship in Health Services and Health of the Public Research.
The European Pediatric HCV Network was funded by a European Commission concerted action grant–Quality of Life and Management of Living Resources Programme, contract number: QLK2-CT-2001-01165.
Address for correspondence: Lucy Pembrey, PhD, Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT. E-mail: email@example.com.
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