INCREASED VERTICAL TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS FROM HEPATITIS-C VIRUS-COINFECTED MOTHERS

To determine if hepatitis C virus (HCV) infection affects vertical tra nsmission of human immunodeficiency virus (HIV), 487 HIV-infected preg nant women in the prospective, multicenter, Women and Infants Transmis sion Study had HCV antibody (anti-HCV by second-generation ELISA) and HCV RNA (by quantitative polymerase chain reaction) measured in peripa rtum maternal plasma; 161 (33%) were anti-HCV-positive, HIV vertical t ransmission occurred from 42 HCV-infected mothers (26.1%) versus 53 HC V-uninfected mothers (16.3%; odds radio [OR], 1.82; P = .01). In a log istic regression model that included maternal drug use, a potential co nfounder, HCV infection was marginally associated with perinatal HIV t ransmission (OR, 1.64; P = .05), whereas drug use was not, Women who t ransmitted HIV had higher levels of HCV RNA (median, 721,254 copies/mL ) than those who did not (337,561 copies/mL; P = .01), Maternal HCV in fection is associated with increased HIV vertical transmission. Furthe r studies are needed to ascertain if HCV directly affects perinatal HI V transmission or is a marker for another factor, such as maternal dru g use.