HCV-HIV coinfected pregnant women: data from a multicentre study in Italy.
OBJECTIVE
To provide information about main pregnancy outcomes in HIV-HCV coinfected women and about the possible interactions between HIV and HCV in this particular population.


METHODS
Data from a multicenter observational study of pregnant women with HIV, conducted in Italian University and Hospital Clinics between 2001 and 2015, were used. Eligibility criteria for analysis were HCV coinfection and at least one detectable plasma HCV-RNA viral load measured during pregnancy. Qualitative variables were compared using the Chi-square or the Fisher test and quantitative variables using the Mann-Whitney U test. The Spearman's coefficient was used to evaluate correlations between quantitative variables.


RESULTS
Among 105 women with positive HCV-RNA, median HCV viral load was substantially identical at the three trimesters (5.68, 5.45, and 5.86 log IU/ml, respectively), and 85.7 % of the women had at least one HCV-RNA value >5 log IU/ml. Rate of preterm delivery was 28.6 % with HCV-RNA <5 log IU/ml and 43.2 % with HCV-RNA >5log (p = 0.309). Compared to women with term delivery, women with preterm delivery had higher median HCV-RNA levels (third trimester: 6.00 vs. 5.62 log IU/ml, p = 0.037). Third trimester HIV-RNA levels were below 50 copies/ml in 47.7 % of the cases. No cases of vertical HIV transmission occurred. Rate of HCV transmission was 9.0 % and occurred only with HCV-RNA levels >5 log IU/ml.


CONCLUSIONS
Coinfection with HIV and HCV has relevant consequences in pregnancy: HIV coinfection is associated with high HCV-RNA levels that might favour HCV transmission, and HCV infection might further increase the risk of preterm delivery in women with HIV. HCV/HIV coinfected women should be considered a population at high risk of adverse outcomes.
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Baroncelli
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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MF
Pirillo
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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R
Amici
Department of Infectious Diseases, Catholic University, Rome, Italy.
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E
Tamburrini
Department of Paediatrics, Catholic University, Rome, Italy.
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O
Genovese
Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
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Ravizza
Department of Paediatrics, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
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A
Maccabruni
Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, Universiy of Turin, Turin, Italy.
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G
Masuelli
Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy.
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G
Guaraldi
I.N.M.I. Lazzaro Spallanzani, Rome, Italy.
G
G
Liuzzi
I.N.M.I. Lazzaro Spallanzani, Rome, Italy.
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C
Pinnetti
Department of Paediatrics, Luigi Sacco Hospital and University of Milan, Milan, Italy.
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V
Giacomet
Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy.
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A
Degli Antoni
Department of Obstetrics and Gynaecology and Policlinic Hospital, University of Bari, Bari, Italy.
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A
Vimercati
Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
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Dalzero
Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
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V
Sacchi
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. floridia@iss.it.
Marco
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Floridia
D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
D012367:RNA, Viral
HCV; HCV transmission; HCV-RNA; HIV; HIV-RNA; Pregnancy; Preterm delivery