Deng Songqing, Zhong Wenfang, Chen Wen, Wang Zilian
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
J Gastroenterol Hepatol. 2023 Feb;38(2):177-186. doi: 10.1111/jgh.15998. Epub 2022 Oct 17.
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.
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.
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 log copies/mL compared with those with viral load < 6 log 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 log copies/mL. HIV coinfection further increased the risk for HCV MTCT.
我们旨在评估感染丙型肝炎病毒（HCV）的孕妇中，母亲HCV病毒载量与人类免疫缺陷病毒（HIV）合并感染之间的关联以及母婴传播（MTCT）的风险。
检索了Medline、Embase、Central、科学引文索引扩展版（SCIE）、会议论文引文索引 - 科学版（CPCIS）、Scopus、拉丁美洲和加勒比地区卫生科学文献数据库（LILACS）以及世界卫生组织全球医学索引数据库，检索时间从数据库建立至2022年6月21日。纳入报告HCV - MTCT发病率的研究。使用随机效应模型计算合并效应估计值，并对多个合并关联进行霍尔姆 - 邦费罗尼校正。
本荟萃分析纳入了26项研究，涉及4934名母亲感染HCV的新生儿。与HCV - RNA阴性的孕妇相比，HCV病毒血症孕妇的MTCT风险增加（优势比[OR] 8.25 [95%置信区间（CI）4.65 - 14.63]）。多项亚组分析显示，HCV病毒血症/HIV阳性组的HCV MTCT风险最高，其次是HCV病毒血症单感染组，而HCV - RNA阴性女性的HCV MTCT风险最低。在HCV病毒血症女性中，病毒载量≥6 log拷贝/mL的受试者与病毒载量<6 log拷贝/mL的受试者相比，MTCT风险升高（OR 4.58 [95% CI：2.52 - 8.34]）。
可检测到HCV病毒血症的孕妇中HCV MTCT发病率增加，病毒载量≥6 log拷贝/mL的孕妇中发病率更高。HIV合并感染进一步增加了HCV MTCT的风险。
