Human immunodeficiency virus-hepatitis C virus co-infection in pregnant women and perinatal transmission to infants in Thailand.
OBJECTIVE
The objectives of this study were to assess the prevalence and factors associated with hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-infected and -uninfected Thai pregnant women and the rate of HCV transmission to their infants.


METHODS
Study subjects included 1435 HIV-infected pregnant women and their infants, enrolled in a perinatal HIV prevention trial, and a control group of 448 HIV-uninfected pregnant women. Women were screened for HCV antibodies with an enzyme immunoassay. Positive results were confirmed by recombinant immunoblot and HCV RNA quantification. Infants were tested for HCV antibodies at 18 months or for HCV RNA at between 6 weeks and 6 months.


RESULTS
Of the HIV-infected women, 2.9% were HCV-infected compared to 0.5% of HIV-uninfected women (p=0.001). Only history of intravenous drug use was associated with HCV infection in HIV-infected women. Ten percent of infants born to co-infected mothers acquired HCV. The risk of transmission was associated with a high maternal HCV RNA (p=0.012), but not with HIV-1 load or CD4 count.


CONCLUSIONS
Acquisition of HCV through intravenous drug use partially explains the higher rate of HCV infection in HIV-infected Thai women than in HIV-uninfected controls. Perinatal transmission occurred in 10% of infants of HIV-HCV-co-infected mothers and was associated with high maternal HCV RNA.
Ngo-Giang-Huong
Nicole
N
Institut de Recherche pour le Développement (IRD), U174 - Program for HIV Prevention and Treatment (PHPT), Faculty of Associated Medical Sciences, Department of Medical Technology, 110 Inthawaroros Road, Muang, 50200 Chiang Mai, Thailand. nicole@phpt.org
Jourdain
Gonzague
G
Sirirungsi
Wasna
W
Decker
Luc
L
Khamduang
Woottichai
W
Le Coeur
Sophie
S
Sirinontakan
Surat
S
Somsamai
Rosalin
R
Pagdi
Karin
K
Hemvuttiphan
Jittapol
J
McIntosh
Kenneth
K
Barin
Francis
F
Lallemant
Marc
M
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications* / Q000635:transmission* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology*; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult; D015215:Zidovudine / Q000008:administration & dosage
D019380:Anti-HIV Agents; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine