Effect of HCV infection on glucose metabolism in pregnant women with HIV receiving HAART.
OBJECTIVE
A prospective study was designed to evaluate the prevalence and determinants of glucose metabolism abnormalities (GMAs) among HIV-1-infected pregnant women receiving highly active antiretroviral therapy (HAART).


METHODS
Blood samples were collected in fasting conditions and following a 100 g oral glucose tolerance test among HIV-infected pregnant women consecutively followed at asingle HIV reference centre in 2001-2008. GMAs were defined by glucose intolerance(IGT) or gestational diabetes (GDM), according to the National Diabetes Data Group criteria. Predictors of GMAs were assessed in univariate and multivariate analyses.


RESULTS
Overall, 78 women with no history of diabetes or GMAs were eligible for analysis. All were on stable HAART with either nevirapine or protease inhibitors (PIs) from at least 4 weeks at the time of sampling. GMAs during pregnancy were observed in 20 women (25.6%; GDM: 6, 7.7%; IGT: 14, 17.9%). In a multivariate analysis, after adjusting for age and ongoing antiretroviral treatment (PI or nevirapine), GMAs in pregnancy were significantly associated with HCV coinfection(adjusted odds ratio 4.16; 95% CI, 1.22-14.1;p = .022). No maternal or neonatalcomplications were observed.


CONCLUSIONS
GMAs represent a relevant issue in the management of HIV-1-infected pregnant women. Our data suggest that these abnormalities are relatively common in this particular group. Women with HCV coinfection have an increased risk of developing GMAs during pregnancy and should be monitored for potential complications.
Department of Infectious Diseases, Catholic University, Rome, Italy.
Carmela
C
Pinnetti
Marco
M
Floridia
Antonella
A
Cingolani
Elena
E
Visconti
Anna Franca
AF
Cavaliere
Lucia Pastore
LP
Celentano And
Enrica
E
Tamburrini
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000209:etiology; D005951:Glucose Tolerance Test; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects*; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D019829:Nevirapine / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
D017320:HIV Protease Inhibitors; D019829:Nevirapine