title: Impact of maternal hepatitis B virus coinfection on mother-to-child transmission of HIV.
abstract: OBJECTIVE
  Despite high hepatitis B virus (HBV) endemicity in various resource-limited settings (RLSs), the impact of maternal HIV/HBV coinfection on infant health outcomes has not been defined. We aimed to assess the prevalence of HBV coinfection among HIV-infected pregnant women and its impact on HIV transmission and infant mortality.
  
  
  METHODS
  In this study, the seroprevalence of HBV coinfection was determined among HIV-infected pregnant women enrolled in the Six-Week Extended-Dose Nevirapine (SWEN) India trial. The impact of maternal HIV/HBV coinfection on mother-to-child transmission (MTCT) of HIV and infant mortality was assessed using univariate and multivariate logistic regression analysis.
  
  
  RESULTS
  Among 689 HIV-infected pregnant Indian women, 32 (4.6%) had HBV coinfection [95% confidence interval (CI) 3.4%, 5.3%]. HBV DNA was detectable in 18 (64%) of 28 HIV/HBV-coinfected women; the median HBV viral load was 155 copies/mL [interquartile range (IQR) < 51-6741 copies/mL]. Maternal HIV/HBV coinfection did not increase HIV transmission risk [adjusted odds ratio (aOR) 1.06; 95% CI 0.30, 3.66; P = 0.93]. Increased odds of all-cause infant mortality was noted (aOR 3.12; 95% CI 0.67, 14.57; P = 0.15), but was not statistically significant.
  
  
  CONCLUSIONS
  The prevalence of active maternal HBV coinfection in HIV-infected pregnant women in India was 4.6%. HIV/HBV coinfection was not independently associated with HIV transmission.
authors.affiliation: Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India; Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: V
authors.initials: V
authors.lastname: Mave
authors.forename: D
authors.initials: D
authors.lastname: Kadam
authors.forename: A
authors.initials: A
authors.lastname: Kinikar
authors.forename: N
authors.initials: N
authors.lastname: Gupte
authors.forename: D
authors.initials: D
authors.lastname: Bhattacharya
authors.forename: R
authors.initials: R
authors.lastname: Bharadwaj
authors.forename: K
authors.initials: K
authors.lastname: McIntire
authors.forename: V
authors.initials: V
authors.lastname: Kulkarni
authors.forename: U
authors.initials: U
authors.lastname: Balasubramanian
authors.forename: N
authors.initials: N
authors.lastname: Suryavanshi
authors.forename: C
authors.initials: C
authors.lastname: Thio
authors.forename: P
authors.initials: P
authors.lastname: Deshpande
authors.forename: J
authors.initials: J
authors.lastname: Sastry
authors.forename: R
authors.initials: R
authors.lastname: Bollinger
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: R
authors.initials: R
authors.lastname: Bhosale
mesh_terms: D000328:Adult; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000401:mortality / Q000635:transmission* / Q000821:virology; D015497:HIV-1; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007226:Infant Mortality; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D016015:Logistic Models; D009035:Mothers; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D016036:Seroepidemiologic Studies; D019562:Viral Load; D055815:Young Adult
keywords: HIV/AIDS; India; hepatitis B virus infection; infant mortality; mother-to-child transmission; perinatal infection; pregnancy