New research suggests HCV coinfection is dangerous for pregnant women with HIV.
Hepatitis C virus (HCV) coinfection increases the risk of preterm birth in women with HIV four-fold to those with lone HIV, according to a new study.
Justyna Kowalska, MD, PhD, of the Hospital for Infectious Diseases and the Medical University of Warsaw, told MD Magazine® the study aimed to give greater clarity to the roles of HCV and HIV in the pregnancies of coinfected women.
“It is well recognized in [the] mono-HCV infected population that HCV replication affects intrauterine fetus growth and can also lead to preterm delivery,” she said.
HIV itself is not associated with preterm delivery, though antiretroviral therapy is. “However, most large HIV studies do not include HCV replication as a potential risk factor,” Kowalska said.
The HIV outpatient clinic at Kowalska’s hospital, however, provided a large enough patient population to study the issue of HIV/HCV coinfection more closely. The researchers looked at data from 2006 to 2017, finding 187 pregnancies.
After excluding pregnancies that ended in abortions and pregnancies where the outcome or combination ART status was unknown, they were left with 159 applicable pregnancies. Of those, 19 (11.9%) concluded with a preterm delivery. Among the women included in the study, 27% had chronic HCV coinfection.
About half (52%) of patients were taking combination ART at the time they became pregnant, and 1 in 5 had a detectable viral load when they went into labor. Kowalska noted that initiating ART prior to pregnancy has been associated with a higher risk of preterm birth, though she said that finding was not replicated in their study, likely due to the small sample size.
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