Risk of Mother-to-Child HIV and HCV Transmission from Coinfected Pregnant Women

By Liz Highleyman

Prior research has indicated that pregnant women coinfected with HIV and hepatitis C virus (HCV) may be more likely to transmit both viruses to their infants during pregnancy or delivery. Two studies presented at the XVII International AIDS Conference this month in Mexico City shed further light on this issue.

Moscow Study

In the first study, I. Simonova, and colleagues assessed 1887 HIV positive pregnant women enrolled at the Moscow Centre for AIDS between 1995 and 2007, 812 of whom (43%) also had HCV. Infants were monitored from birth through 18 months.

Results

• 79 HIV monoinfected women (7.3%) transmitted HIV to their babies, compared with 89 HIV-HCV coinfected women (11.0%).

• Among the coinfected women, 75 (9.2%) transmitted HCV only.

• 33 infants (4.0%) were infected with both viruses.

The researchers concluded that HIV-HCV coinfection in pregnant women increases the rate of perinatal HIV transmission.

They also reported that infants cleared their mothers' HCV antibodies sooner than HIV antibodies after birth (12 vs 18 months), which has implications for the timing of testing to determine whether babies are truly infected.

Moscow Center of AIDS, Moscow, Russian Federation

Buenos Aires Study

In the second study, M. Lencina and colleagues from Argentina followed a cohort of children born to HIV-HCV coinfected women from 1988 through 2006. Data were monitored retrospectively during 1988-1991, then prospectively during 1992-2006. The study initially included 86 mother-child pairs, but 7 dropped out.

Results

• In an analysis of the 79 remaining mother-infant pairs, a total of 6 infants (7.6%) were infected with HCV:

• 4 infants (5.1%) infected with HCV alone;

• 2 infants (2.5%) infected with both HCV and HIV (born before prophylactic antiretroviral therapy came into widespread use).

• Among the HCV infected children, only 1 cleared the virus, leaving 5 (83.3%) with chronic hepatitis C.

• 1 child progressed to periportal fibrosis.

Infectologia Pediatrica Hospital Interzonal EVITA, Provincia de Buenos Aires, Lanus, Argentina; Laboratorio Central Hospital EVITA, Lanus, Argentina; Infectologia Pediatrica Hospital EVITA, Lanus, Argentina.

Together, these studies support prior research showing that HIV-HCV coinfected women are at greater risk for transmitting the viruses to their infants, suggesting a role for antiviral therapy to lower HCV viral load (as is already now standard practice for HIV), and possibly Cesarean section.

8/22/08

References

I Simonova, M Geine, J Vlatskaya, and others. HIV/HCV coinfection: study of mother-to-infant transmission of HIV and HCV. XVII International AIDS Conference (AIDS 2008). Mexico City. August 3-8, 2008. Abstract WEPE0176.

M Lencina, M D'Ambrosio, D Martinez, and others. Vertical transmission of HCV on women co infected with HIV/HCV: 18 years of monitoring at a general hospital in Buenos Aires. XVII International AIDS Conference (AIDS 2008). Mexico City. August 3-8, 2008. Abstract CDB0136.