title: Low mother-to-child-transmission rate of Hepatitis C virus in cART treated HIV-1 infected mothers.
abstract: BACKGROUND
  Maternal transmission is the most common cause of HCV infection in children. HIV co-infection and high levels of plasma HCV-RNA have been associated with increased HCV transmission rates.
  
  
  OBJECTIVE
  We assessed the vertical HCV transmission rate in the HIV-HCV co-infected group of pregnant women on cART.
  
  
  METHODS
  We conducted a retrospective study in a Dutch cohort of HIV-positive pregnant women and their children. We identified co-infected mothers. Results of the HCV tests of the children were obtained.
  
  
  RESULTS
  All 21 women were on cART at the time of delivery. We analyzed data of the 24 live-born children at risk for mother-to-child transmission (MTCT) of HCV between 1996 and 2009. HIV-RNA was <500 copies/ml during 18/24 [75%] deliveries, the median CD4(+) cell count was 419 cells/μl (290-768). There was no transmission of HIV. The median plasma HCV-RNA in our cohort of 23 non-transmitting deliveries in 21 women was 3.5×10E5 viral eq/ml (IQR 9.6×104-1.5×106veq/mL). One of 24 live-born children was found to be infected with HCV genotype 1. At the time of delivery the maternal plasma HIV-RNA was <50 copies/ml, the CD4(+) cell count was 160 cells/μl and maternal plasma HCV-RNA was 4.6×10E6 veq/ml. This amounted to a prevalence of HCV-MTCT of 4%.
  
  
  CONCLUSIONS
  In this well-defined cohort of HIV-HCV co-infected pregnant women, all treated with cART during pregnancy, a modest rate of vertical HCV transmission was observed.
authors.affiliation: Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Internal Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands. Electronic address: iSnijdewind@gmail.com.
authors.forename: I J M
authors.initials: IJ
authors.lastname: Snijdewind
authors.affiliation: HIV Monitoring Foundation, Amsterdam, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Smit
authors.affiliation: Viroloclinics, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Schutten
authors.affiliation: Department of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: F J B
authors.initials: FJ
authors.lastname: Nellen
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: F P
authors.initials: FP
authors.lastname: Kroon
authors.affiliation: HIV Monitoring Foundation, Amsterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Reiss
authors.affiliation: Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: van der Ende
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012189:Retrospective Studies
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; Hepatitis C; Pregnancy; Vertical transmission; cART