HIV, hepatitis coinfection and TB

How easy is it to transmit hepatitis C from mother to baby?

If you are coinfected with hepatitis C virus (HCV) and HIV—you may discover this through routine screening in pregnancy—there is a risk of transmission of HCV of up to 15 percent.

Treating your HIV will reduce this risk of transmitting HCV.

BHIVA guidelines recommend a planned Caesarean section delivery for those who are coinfected.

What about hepatitis B?

It is very likely that mothers with active hepatitis B virus (HBV) will transmit to their babies (90 percent). Immunising the baby against HBV shortly after he or she is born can prevent transmission of hepatitis B.

This is standard practice in the UK.

It may be appropriate for the mother’s combination to include HIV drugs that also work against HBV, in particular 3TC or FTC and tenofovir.

HIV and TB coinfection

It is important to treat TB in pregnancy. Additionally HIV/TB coinfection increases the risk of mother-to-child transmission of both infections. TB can also increase the risk of the less common in utero (in the womb rather than during labour) mother-to-child transmission of HIV.

Like HIV, TB is a much greater risk to a pregnant woman and her infant than its treatment or prophylaxis.

Most TB first line TB drugs are safe to use in pregnancy.

However, the TB drug streptomycin is not recommended in pregnancy as it can cause permanent deafness in the baby.

This drug is now only rarely used in the treatment of TB in the UK.