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<sup>+</sup> 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<sup>+</sup> 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.

CART, Hepatitis C, HIV, Pregnancy, Vertical transmission,
Journal of Clinical Virology
Department of Internal Medicine

Snijdewind, I.J.M, Smit, C, Schutten, M, Nellen, F.J.B, Kroon, F.P, Reiss, P, & van der Ende, M.E. (2015). Low mother-to-child-transmission rate of Hepatitis C virus in cART treated HIV-1 infected mothers. Journal of Clinical Virology, 68, 11–15. doi:10.1016/j.jcv.2015.04.002