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15 April 2007

Volume 44, Number 8
Clinical Infectious Diseases 2007;44:1123–1131
© 2007 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4408-0020$15.00
DOI: 10.1086/512815
HIV/AIDS MAJOR ARTICLE

Impact of Maternal HIV Coinfection on the Vertical Transmission of Hepatitis C Virus: A Meta‐analysis

Chelsea B. Polis,1

Snehal N. Shah,2

Kristine E. Johnson,3 and

Amita Gupta3

Departments of 1Population, Family and Reproductive Health and 2Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, and 3Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland

Background.Observational studies suggest that maternal human immunodeficiency virus (HIV)–hepatitis C virus (HCV) coinfection is associated with increased odds of vertical HCV transmission. We performed a meta‐analysis to summarize current evidence.

Methods.We systematically searched for relevant articles published during the period from January 1992 through July 2006 and independently abstracted articles that met our inclusion criteria. Under a random effects model, we calculated the pooled odds ratio for vertical HCV transmission according to maternal HIV‐HCV coinfection status and performed sensitivity analyses.

Results.Ten articles met our inclusion criteria. Study quality varied widely, and study estimates displayed high statistical heterogeneity. Restriction of the analysis to studies that included >50 HIV‐HCV–coinfected women provided our most reliable estimate: maternal HIV‐HCV coinfection increases the odds of vertical HCV transmission by 90% (odds ratio, 1.9; 95% confidence interval, 1.36–2.67), compared with maternal HCV infection alone. When we restricted analyses to HIV‐infected mothers with HCV viremia, the odds of vertical HCV transmission were 2.82‐fold (95% confidence interval, 1.17‐fold to 6.81‐fold) greater than the odds for HIV‐infected mothers without HCV viremia.

Conclusions.HIV‐HCV–coinfected women have significantly higher odds of transmitting HCV to their infants than do women who are infected with HCV alone.

Received 16 October 2006; accepted 5 January 2007; electronically published 7 March 2007.

Reprints or correspondence: Chelsea Polis, Dept. of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Rm. W4510, Baltimore, MD 21205 ().

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