Valérie Benhammou1, Roland Tubiana2, Sophie Matheron3, Pierre Sellier4, Laurent Mandelbrot5,6, Jérôme Le Chenadec6, Emmanuelle Marel6, Babak Khoshnood1, Josiane Warszawski6,7. 1. Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France. 2. Department of Infectious Diseases, AP-HP Hôpital Pitié-Salpêtrière, Paris-Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France. 3. Department of Infectious Diseases, AP-HP, Hôpital Bichat, Paris-IAME UMR 1137 INSERM Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France. 4. Department of Internal Medicine, AP-HP, Hôpital Lariboisière, Paris, France. 5. Department of Obstetrics and Gynecology, AP-HP Hôpital Louis Mourier, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France. 6. Department of Epidemiology, Centre de Recherche en Épidémiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Le Kremlin-Bicêtre, France. 7. Univ Paris-Saclay, Le Kremlin-Bicêtre, AP-HP Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
Abstract
BACKGROUND: 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.
BACKGROUND:Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is frequent in HIV-infectedpersons but their impact on pregnant HIV-infectedwomen 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-infectedwomen 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-infectedwomen, 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.
Authors: Sara Domínguez-Rodríguez; Luis Prieto; Carolina Fernández McPhee; Marta Illán-Ramos; José Beceiro; Luis Escosa; Eloy Muñoz; Iciar Olabarrieta; Francisco Javier Regidor; Miguel Ángel Roa; María Del Carmen Viñuela Beneítez; Sara Guillén; Maria Luisa Navarro-Gómez; José Tomás Ramos Amador Journal: PLoS One Date: 2020-04-09 Impact factor: 3.240
Authors: Jolien J M Freriksen; Minou van Seyen; Ali Judd; Diana M Gibb; Intira J Collins; Rick Greupink; Frans G M Russel; Joost P H Drenth; Angela Colbers; David M Burger Journal: Aliment Pharmacol Ther Date: 2019-08-25 Impact factor: 8.171