Higher hepatitis viral load increases risk of vertical transmission

Pregnant women with higher viral loads of hepatitis C virus (HCV) are at an increased risk of transmitting the virus to their offspring.

A team, led by Songqing Deng, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, assessed the link between maternal HCV viral load and HIV coinfection and the risk for mother-to-child transmission among pregnant women infected with HCV.

The Study

In the study, the investigators explored various databases from inception to June 21, 2022 that reported the incidence of HCV mother-to-child transmission.

They calculated pooled effect estimates using the random-effects model and Holm-Bonferroni correction for multiple pooled associations.

Associations

The final analysis included 26 studies involving 4934 newborns with maternal HCV infections. The investigators found pregnant women with HCV viremia showed an increased risk of mother-to-child transmission (OR, 8.25; 95% CI, 4.65-14.63) compared to those with negative for HCV-RNA.

After conducting multiple subgroup analysis, the investigators found that the HCV viremia/HIV-positive group had a higher risk of HCV mother-to-child transmission, followed by the HCV viremia mono-infected group.

On the other hand, HCV-RNA-negative women showed the lowest risk for HCV mother-to-child transmission.

For female patients with HCV viremia, the elevated risk of mother-to-child transmission was found among subjects with a viral load ≥6 log10 copies/ml compared to those with viral load < 6 log10 copies/ml (OR, 4.58; 95% CI, 2.52–8.34).

“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,” the authors wrote. “HIV coinfection further increased the risk for HCV MTCT.”

Recently, a new analysis of pregnant women in India shows mostly vertical transmission of hepatitis B virus (HBV).

A team, led by Suprabhat Giri, Department of Gastroenterology, Nizam's Institute of Medical Sciences, determined the pooled seroprevalence of HBV and its associated demographic factors.

HBV infections during pregnancy can often lead to perinatal transmission of the virus, contributing to the pool of HBV infections within the population. However, there is a wide variation in the data reported on the seroprevalence of HBV in pregnancy patients from various regions in India.

The pooled prevalence of hepatitis B e antigen was 26.0% (95% CI, 17.4-34.7) among patients with HBsAg positivity.

However, the investigators did not find significant differences in the odds of HBV seroprevalence based on the age (<25 years vs. > 25 years) (OR, 1.07; 95% CI, 0.74–1.55), parity (primipara vs. multipara) (OR, 1.09; 95% CI, 0.70–1.70), or area of residence (urban vs. rural) (OR, 0.88; 95% CI, 0.56–1.39).

On the other hand, the odds of HBV seroprevalence in participants with no or primary education was higher than individuals with secondary level education or higher (OR, 2.29; 95% CI, 1.24–4.23).

The investigators also found a prior history of risk factor was identified in 13.5-22.7% of patients, which indicates a vertical mode of acquisition.

The study, “Hepatitis C viral load and mother-to-child transmission: a systematic review and meta-analysis,” was published online in the Journal of Gastroenterology and Hepatology.

This article originally appeared on HCPLive®.