Prevalence of hepatitis C virus infection among human immunodeficiency virus-1-infected pregnant women in Malawi: the BAN study.
BACKGROUND
In Sub-Saharan Africa, prevalence estimates of hepatitis C virus (HCV) vary widely.


OBJECTIVE
To assess the prevalence of HCV infection among HIV-infected, pregnant women screened for a large clinical trial in Lilongwe, Malawi.


METHODS
Plasma from 2041 HIV-infected, pregnant women was screened for anti-HCV IgG using a chemiluminiscent immunometric assay (CIA). Specimens with a signal-cut-off ratio≥1.00 were considered reactive and those with S/Co ratio<1.00 non-reactive. All CIA-reactive specimens were tested by a recombinant immunoblot assay (RIBA) for anti-HCV and by PCR for HCV RNA.


RESULTS
Of 2041 specimens, 110 (5.3%, 95% CI: 4.5-6.5%) were CIA reactive. Of the 109 CIA reactive specimens available for RIBA testing, 2 (1.8%) were positive, 28 (25.7%) were indeterminate, and 79 (72.5%) were negative. All CIA-reactive specimens were HCV RNA negative (n=110). The estimated HCV prevalence based on the screening assay alone was 5.3%; based on supplemental RIBA testing, the status of HCV infection remained indeterminate in 1.4% (28/2040, 95% CI: 0.1-2.0) and the prevalence of confirmed HCV infections was 0.1% (2/2040, 95% CI: 0-0.4%).


CONCLUSIONS
HCV seroprevalence among HIV-infected, pregnant women in Malawi confirmed by supplemental RIBA HCV 3.0 is low (0.1%); CIA showed a high false-reactivity rate in this population.
UNC Project, Lilongwe, Malawi.
Charles S
CS
Chasela
Patrick
P
Wall
Jan
J
Drobeniuc
Caroline C
CC
King
Eyasu
E
Teshale
Mina C
MC
Hosseinipour
Sascha R
SR
Ellington
Mary
M
Codd
Denise J
DJ
Jamieson
Rodney J
RJ
Knight
Patricia
P
Fitzpatrick
Athena P
AP
Kourtis
Irving F
IF
Hoffman
Dumbani
D
Kayira
Noel
N
Mumba
Deborah D
DD
Kamwendo
Francis
F
Martinson
William
W
Powderly
Charles
C
van der Horst
Saleem
S
Kamili
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008295:Malawi / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*; D055815:Young Adult
D018937:Hepatitis C Antibodies; D007074:Immunoglobulin G; D012367:RNA, Viral