In:
JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 77, No. 5 ( 2018-04-15), p. 439-450
Abstract:
Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is frequent in HIV-infected persons but their impact on pregnant HIV-infected women is understudied. We explored whether these coinfections are associated with adverse pregnancy outcomes and lower response to antiretroviral therapy (ART). Methods: Pregnancies in HIV-1–infected women included in the ANRS French Perinatal Cohort between 2005 and 2013 were analyzed if HBV and HCV infection statuses were available. Results: Among 4236 women, the prevalence of HBV (HBs Ag+) and HCV (RNA+) were 6.2% (95% confidence interval: 5.4 to 6.8) and 1.7% (1.3 to 2.1), respectively. HCV coinfection was strongly associated with a history of drug use; HBV coinfection was 6 times more frequent in women born in Sub-Saharan Africa than in European France. Baseline HIV viral load, CD4 count, and HIV care during pregnancy were similar in coinfected and monoinfected HIV mothers, except that 90% of HBV/HIV women were receiving tenofovir and/or lamivudine or emtricitabine. HCV coinfection was significantly associated with cholestasis [adjusted odds ratio: 4.1 (1.5–10.8), P = 0.005], preterm delivery [3.0 (1.6–5.7), P 〈 0.001], lower CD4 [2.6 (1.0–6.4), P 〈 0.001] , and detectable viral load [2.3 (1.0–5.5), P = 0.06] at the end of pregnancy. HBV coinfection was not associated with any of these outcomes. Conclusions: In HIV-infected women, chronic HBV infection, mostly treated using targeted ART, had no major impact on the course of pregnancy. By contrast, chronic HCV infection was associated with a higher risk of obstetrical complications and a poorer immune–virological response to ART. It is yet unknown whether cure of HCV infection before conception can limit these adverse outcomes.
Type of Medium:
Online Resource
ISSN:
1525-4135
DOI:
10.1097/QAI.0000000000001618
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
2038673-4
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