Hepatitis C viral load and mother‐to‐child transmission: A systematic review and meta‐analysis

• Published in: Journal of gastroenterology and hepatology Vol. 38; no. 2; pp. 177 - 186
• Main Authors: Deng, Songqing, Zhong, Wenfang, Chen, Wen, Wang, Zilian
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.02.2023
• Subjects: Citation indexes; Coinfection; Female; HCV viral load; Hepacivirus; Hepatitis C; hepatitis C virus; HIV; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Meta-analysis; Mothers; mother‐to‐child transmission; Neonates; Pregnancy; Pregnancy Complications, Infectious - epidemiology; RNA; Viral Load; Viremia; hepatitis C virus; HIV; HCV viral load; mother-to-child transmission
• ISSN: 0815-9319; 1440-1746; 1440-1746
• DOI: 10.1111/jgh.15998

Background and Aim We aim to assess the association between maternal hepatitis C virus (HCV) viral load and human immunodeficiency virus (HIV) coinfection and the risk for mother‐to‐child transmission (MTCT) among pregnant women infected with HCV. Methods A literature search of the Medline, Embase, Central, Science Citation Index Expanded (SCIE), Conference Proceedings Citation Index‐Science (CPCIS), Scopus, Literature Latino‐Americana e do Caribe em Ciências da Saúde (LILACS), and WHO Global Index Medicus databases, from inception to June 21, 2022, was performed. Studies that reported the incidence HCV‐MTCT were included. Pooled effect estimates were calculated using the random‐effects model, and Holm–Bonferroni correction was performed for multiple pooled associations. Results The present meta‐analysis included 26 studies involving 4934 newborns with maternal HCV infection. Pregnant women with HCV viremia exhibited increased risk for MTCT (odds ratio [OR] 8.25 [95% confidence interval (CI) 4.65–14.63]) compared with those negative for HCV‐RNA. Multiple subgroup analysis revealed that the HCV viremia/HIV‐positive group demonstrated the highest risk for HCV MTCT, followed by the HCV viremia mono‐infected group, while HCV‐RNA‐negative women demonstrated the lowest risk for HCV MTCT. Among females with HCV viremia, elevated risk for MTCT was found among subjects with a viral load ≥ 6 log10 copies/mL compared with those with viral load < 6 log10 copies/mL (OR 4.58 [95% CI: 2.52–8.34]). Conclusion The incidence of HCV MTCT was increased among pregnant women with detectable HCV viremia and was even higher in those with a viral load ≥ 6 log10 copies/mL. HIV coinfection further increased the risk for HCV MTCT.