Perinatal transmission rates and effect of mode of delivery
We compiled data from 11 studies that reported the perinatal transmission rate of HCV associated with various modes of delivery. These studies were selected from a MEDLINE literature review from 1999 to 2019. The studies were screened first by title and, subsequently, by abstract. Inclusion was restricted to randomized controlled trials, cohort studies, and case-control studies written in English. Study quality was assessed as good, fair, or poor based on the study design, sample size, and statistical analyses performed. The results from the total population of each study are reported in TABLE 2.14,20-29
Three studies separated data based on the mother's HIV status. The perinatal transmission rates of HCV for mothers co-infected with HIV are reported in TABLE 3.23,27 The results for HIV-negative mothers are reported in TABLE 4.14,23
Finally, 2 studies grouped mothers according to their HCV viral load. All of the mothers in these studies were anti-HCV antibody positive, and the perinatal transmission rates for the total study populations were reported previously in TABLE 2. The results for mothers who had detectable HCV RNA are reported in TABLE 5.20,21 High viral load was defined as
≥ 2.5 x 106 Eq/mL in the study by Okamoto and colleagues, which is equivalent to ≥ 6.0 x 105 IU/mL in the study by Murakami and colleagues due to the different assays that were used.20,21 The perinatal transmission rates for mothers with a high viral load are presented in TABLE 6.20,21
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