[994] HIV-1/HCV CO-INFECTION IN PREGNANT WOMEN AND THEIR INFANTS IN THAILAND

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] HIV-1/HCV CO-INFECTION IN PREGNANT WOMEN AND THEIR INFANTS IN THAILAND

[AUTHOR(S):] N Ngo-Giang-Huong¹, W Sirirungsi², W Khamduang³, W Bunprasit³, T Roederer³, F Barin⁴ and M Lallemant³
¹IRD054 Harvard School of Public Health, Chiang Mai, Thailand; ²AMS faculty, Chiang Mai, Thailand; ³IRD054/PHPT Chiang Mai, Thailand; and ⁴Universite Tours, Tours, France

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 994
Antiviral Therapy 2003; 8(Suppl. 1):S465

[ABSTRACT:] Background: In Thailand, HIV-1 prevalence in pregnant women reaches 1.5% and little is known about HIV-1/HCV co-infection in this population.

Objectives: To assess the HCV prevalence in HIV-1 infected pregnant women, HCV perinatal transmission rate and to explore the association between maternal HIV-1/HCV viral loads and HIV-1 and HCV perinatal transmissions.

Population: 1,437 HIV-1 positive pregnant women enrolled from 1997 to 1999 in a perinatal HIV prevention trial in Thailand (PHPT-1), where AZT treatments of various durations in mothers and infants were compared (infants were not breastfed). A control group of 448 non-HIV infected pregnant women matched on age and enrolment site.

Methods: Maternal HCV serology was assessed at 26 weeks of gestational age (Murex anti-HCV kit, v 4.0 confirmed by immunoblot, Bioblot HCV). Infants born to HCV+ mothers were considered HCV-infected if positive for HCV serology at 18 months of age and/or positive for HCV RNA before the age of 6 months (CA HCV Monitor Test, v 2.0, Roche Diagnostic).

Results: HCV seroprevalence was 2.9% (42/1437) in HIV+ women vs 0.5% (2/448) in HIV- controls, P=0.001. Among HIV+/HCV+ women, 71 % (30/42) had circulating HCV RNA (3.61–6.12 log₁₀ UI/ml). No correlation was observed between maternal HIV and HCV viraemia (NS). HCV perinatal transmission rate was 9.5% (4/42) in HIV+/HCV+ mothers and was associated with a high HCV viral load (P=0.001), all transmitting mothers having HCV RNA over 5.6 log₁₀ UI/ml. HCV perinatal transmission was not associated with HIV-1 viral load. The rate of HIV perinatal transmission was 4.8% (2/42) in HIV+/HCV+ mothers vs 7.0% (97/1373) in HIV+/HCV+ mothers (NS).

Conclusions: In Thailand, HCV seroprevalence is higher in HIV+ than in HIV- pregnant women. HCV transmission is only observed with high maternal HCV viral load independently of HIV viral load. Co-infection by HCV does not seem to facilitate HIV perinatal transmission.

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