Low mother-to-child-transmission rate of Hepatitis C virus in cART treated HIV-1 infected mothers

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. Objectives: We assessed the vertical HCV transmission rate in the HIV-HCV co-infected group of pregnant women on cART. Study design: 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 <500copies/ml during 18/24 [75%] deliveries, the median CD4⁺ cell count was 419cells/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 <50copies/ml, the CD4⁺ cell count was 160cells/μl and maternal plasma HCV-RNA was 4.6×10E6veq/ml. This amounted to a prevalence of HCV-MTCT of 4%. Conclusion: 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.

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