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MOTHER-TO-CHILD TRANSMISSION OF HEPATITIS C VIRUS (HCV) AMONG HIV/HCV-COINFECTED WOMEN
Author
Affilliation
Hospital General de Agudos Jose Maria Ramos Mejia. Department of Medicine. HIV Unit. Buenos AIres, Argentina.
Westat. Rockville, Maryland. USA.
Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomedicas en Retrovirus y SIDA. Buenos Aires, Argentina.
Hospital General de Agudos Jose Maria Ramos Mejia. Department of Medicine. HIV Unit. Buenos AIres, Argentina.
Hospital General de Agudos Jose Maria Ramos Mejia. Department of Medicine. HIV Unit. Buenos AIres, Argentina.
Hospital Femina. Vertical Transmission Prevention Unit. Porto Alegre, RS, Brasil.
Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratorio de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomedicas en Retrovirus y SIDA. Buenos Aires, Argentina.
Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.
National Institute of Health. Eunice Kennedy Shriver National Institute of Child Health. Pediatric, Adolescent, and Maternal AIDS Branch. Bethesda, Maryland, USA.
Westat. Rockville, Maryland. USA.
Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomedicas en Retrovirus y SIDA. Buenos Aires, Argentina.
Hospital General de Agudos Jose Maria Ramos Mejia. Department of Medicine. HIV Unit. Buenos AIres, Argentina.
Hospital General de Agudos Jose Maria Ramos Mejia. Department of Medicine. HIV Unit. Buenos AIres, Argentina.
Hospital Femina. Vertical Transmission Prevention Unit. Porto Alegre, RS, Brasil.
Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratorio de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomedicas en Retrovirus y SIDA. Buenos Aires, Argentina.
Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.
National Institute of Health. Eunice Kennedy Shriver National Institute of Child Health. Pediatric, Adolescent, and Maternal AIDS Branch. Bethesda, Maryland, USA.
Abstract
Background. Maternal human immunodeficiency virus (HIV) coinfection has been associated with
increased hepatitis C virus (HCV) mother-to-child transmission (MTCT). We hypothesized that HCV/HIVcoinfected
women with well-controlled HIV disease would not have increased HCV MTCT.
Methods. The NISDI Perinatal and LILAC cohorts enrolled HIV-infected pregnant women and their
infants in Latin America and the Caribbean. This substudy evaluated the HCV infection status of mothers at
participating sites and their live born, singleton infants who had a 6-month postnatal visit by December
31, 2008. Mothers who were anti-HCV-positive, or who had CD4 counts (cells/mm3
) <200 with detectable
HCV RNA, were considered HCV-infected. All HCV-infected women were tested for HCV RNA. Infants
with HCV RNA were considered HCV-infected.
Results. Of 1042 enrolled women, 739 (71%) mother-infant pairs met the inclusion criteria. Of the 739
women, 67 (9%) were anti-HCV-positive and 672 anti-HCV-negative [68 (10%) with CD4 counts <200; of
these, 3 (4.4%) were HCV RNA-positive]. Therefore, our study population comprised 70 HCV-infected (47
with HCV RNA) and 669 HCV-uninfected women (and their infants). Factors associated with maternal
HCV infection included unemployment (odds ratio [OR] = 2.58); tobacco (OR = 1.73) or marijuana
(OR = 3.88) use during pregnancy; enrollment HIV viral load ([VL] copies/mL) 10 000 (OR = 2.27); HIV
clinical disease stage C (OR = 2.12); and abnormal alanine aminotransferase (OR = 4.24) or aspartate
aminotransferase (OR = 11.98). Four of 47 infants (8.5%) born to HCV-viremic women were HCV-infected,
and all 4 mothers had HIV VL <1000 at hospital discharge after delivery.
Conclusions. HCV MTCT among HIV/HCV-coinfected women with well-controlled HIV disease may be
lower than reported in other coinfected populations. Studies with longer infant follow-up are needed.
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