HIV, hepatitis coinfection and TB

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

If you are co-infected 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%. Treating your HIV will reduce this risk of transmitting HCV.

BHIVA guidelines recommend a planned C-section delivery for those who are co-infected.

What about hepatitis B?

It is very likely that mothers with active hepatitis B virus (HBV) will transmit to their babies (90%). Transmission can be prevented by immunising the baby against HBV shortly after he or she is born.

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 and tenofovir.

HIV and TB co-infection

It is important to treat TB in pregnancy. Additionally HIV/TB coinfection increases the risk of mother-to-child- transmission  o 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.

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.