title: HCV viremia is associated with drug use in young HIV-1 and HCV coinfected pregnant and non-pregnant women.
abstract: OBJECTIVE
  Vertical transmission of HCV is increased among HIV-1/HCV coinfected women and is related to HCV viral load. In this study we assessed clinical and demographic factors associated with HCV viremia in a cohort of young pregnant and non-pregnant mothers coinfected with HIV-1.
  
  
  METHODS
  A cross-sectional clinic-based study nested within a prospective cohort study.
  
  
  METHODS
  From 1988 to 2000, HIV-1 + pregnant and non-pregnant women with children followed in a large maternal, child and adolescent HIV-1 clinic were evaluated for HCV infection using EIA 3.0. HCV RNA levels were determined for HCV antibody + women using polymerase chain reaction. Demographic and clinical characteristics between HCV-RNA(+) and HCV-RNA(-) women and between pregnant and non-pregnant HIV-1/HCV coinfected women were compared using univariate and multivariate analyses.
  
  
  RESULTS
  Among 359 HIV-1(+) women, 84 (23%) were HCV-ab + and 49/84 (58%) had detectable HCV-RNA in plasma. Median age was 31. CD4 counts, HIV-1 RNA levels and demographic characteristics were similar for viremic and non-viremic women and pregnant and non-pregnant women. However, viremic women were more likely to report a history of (88% versus 43%; P < 0.001) or active injection drug use (AIDU) (83% versus 29%; P < 0.001). Logistic regression analysis showed that HCV viremia was associated significantly with AIDU (adjusted OR: 15.17; 95% CI: 3.56, 64.56) after adjusting for age, race, number of sexual partners, pregnancy status, CD4 counts and HIV-1 viral load.
  
  
  CONCLUSIONS
  In this cohort of young HIV-1 and HCV coinfected women, HCV viremia was associated strongly with active injection drug use, perhaps due to reinfection or reactivation of HCV. Thus, careful evaluation for HCV infection and counseling related to drug use may be necessary.
authors.affiliation: Maternal, Child and Adolescent Center for Infectious Diseases and Virology, Los Angeles County and University of Southern California Medical Center, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Georgia B
authors.initials: GB
authors.lastname: Nikolopoulou
authors.forename: Marek J
authors.initials: MJ
authors.lastname: Nowicki
authors.forename: Wenbo
authors.initials: W
authors.lastname: Du
authors.forename: James
authors.initials: J
authors.lastname: Homans
authors.forename: Alice
authors.initials: A
authors.lastname: Stek
authors.forename: Francoise
authors.initials: F
authors.lastname: Kramer
authors.forename: Andrea
authors.initials: A
authors.lastname: Kovacs
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011446:Prospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications*; D019562:Viral Load; D014766:Viremia / Q000209:etiology*