title: Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions.
abstract: Human immunodeficiency virus type 1 (HIV-positive) pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs). The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8% for HCV, 2.3% for chronic HBV, 3.1% for syphilis and 40.8% for HPV. Of those co-infected with HPV, 52.9% presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil.
authors.forename: Michele
authors.initials: M
authors.lastname: Tornatore
authors.forename: Carla Vitola
authors.initials: CV
authors.lastname: Gonçalves
authors.forename: Mônica Steigleder
authors.initials: MS
authors.lastname: Bianchi
authors.forename: Fabiana Nunes
authors.initials: FN
authors.lastname: Germano
authors.forename: Alzira Xavier
authors.initials: AX
authors.lastname: Garcés
authors.forename: Marcelo Alves
authors.initials: MA
authors.lastname: Soares
authors.forename: Elizabeth Stankiewicz
authors.initials: ES
authors.lastname: Machado
authors.forename: Ana Maria Barral
authors.initials: AM
authors.lastname: de Martinez
mesh_terms: D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology / Q000821:virology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D011256:Pregnancy Outcome; D015995:Prevalence; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral