COURSE AND CONSEQUENCES OF PREGNANCY IN HIV-POSITIVE WOMEN WITH HCV-INFECTION
DOI:
https://doi.org/10.11603/1681-2727.2019.1.9940Keywords:
HCV-infection, co-HIV-infection, pregnancy, vertical transmissionAbstract
Today, the problem of HCV-infection in pregnant women is extremely important in the context of the HIV/AIDS epidemic in Ukraine. As there is a tendency to the increase of the number of pregnant women, infected with HIV and parenteral hepatotropic viruses, the risk of their vertical transmission also rises.
The aim of the work – to analyze the frequency and the nature of obstetric-perinatal complications, intrauterine fetal infections in HIV-positive pregnant women with different forms of HCV-infection.
Patients and methods. The course and effects of pregnancy were studied in 30 co-infected HCV+HIV pregnant women, 102 pregnant women who were infected with HCV with negative HIV-status served as a comparison group.
In order to verify HCV-infection serial markers were determined by ELISA and viral load was estimated by PCR in each trimester of pregnancy. The children were examined for HCV in 3 and 6 months of life, and if necessary – in 12 and for anti-HCV in 18 months. In the presence of clinical indications (jaundice, hepatolienal syndrome) children were examined earlier.
Research results. Among pregnant women with HIV-positive status, replication forms were diagnosed in 53.3 % of women, and latent – in 46.7 %. In pregnant women with negative HIV-status, replication forms of HCV-infection occurred in 60.8 % of women, and latent – in 39.2 %.
The frequency of abnormal conditions during pregnancy depended on the clinical form of the disease and the mother’s HIV-status and was significantly higher in women with positive HIV-status and replicative forms of HCV-infection than with latent ones (р˂0.05–0.001).
The complicated course of labor was more likely in women with replicative forms and positive HIV status than with negative ones (р˂0.05). Complications such as rapid births and maternal breakdowns were more often diagnosed in women without HIV-infection (р˂0.05), which is associated with a much lower frequency of сaesarean section in HIV-positive women. The rate of reproductive loss was higher in women co-infected with HIV than in women without HIV-infection and was 23.3 % versus 4.9 % respectively, and the incidence of congenital HCV-infection was 13.3 % versus 1.9 % respectively.
There were no cases of birth of infected children in women with latent forms of HCV-infection with both positive and negative HIV-status.
Conclusions. HCV-infection is the cause of obstetric and perinatal complications, intrauterine infection of the fetus. The frequency of obstetric-perinatal complications is higher in pregnant women co-infected with HCV+HIV than in women with mono-infection. In women with HIV-positive status, the incidence of reproductive loss is 4.7 times higher, and the incidence of congenital HCV infection is 7 times higher.
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