Course of HBV-infection in HIV-infected and HIV-non-infected Pregnant women

Abstract

The objective of the work – is to study the course of HBV-infection in pregnant women, infected and uninfected with HIV, based on the analysis of clinical-laboratory parameters.
 Materials and methods. HBV-infection was diagnosed in 5.6% of women with negative HIV-status and in 9.4% positive with HIV.
 To verify the diagnosis of HBV-infection, the data of anamnesis, clinical examination, laboratory tests: general clinical, biochemical, EIA, PCR, and VL in each trimester of pregnancy were used.
 Research. In HIV-negative pregnant women, 71.6% of the patients were diagnosed with HBsAg carrier status and 28.4% – the replication stages. Replication stages were only in HIV-positive patients.
 The frequency of clinical manifestations of CHB is higher in HIV-positive women – it is 33.33% vs 10.00% in HIV-negative (p<0.05), in a significantly lower rate of cytolysis – 11.11% vs 45.00% (p< 0.001), which did not increase up to the childbirth.
 The rate of VL of HBV increased before the childbirth in 63.3% of pregnant women without HIV-infection, and in 36.7% it did not change. Thus, in 83.3% of HIV-infected, it decreased to the threshold, and in 16.7% it hasn’t changed (p<0.01).
 During pregnancy, the immunotolerant phase of CHB in women of both groups was not transformed into immunoactive, and in HIV-negative pregnant women – the carrier status of HBsAg to the replicative form.
 Conclusion. In pregnant women with HIV-infection the incidence of replicative forms of HBV-infection is 3.5 times than in pregnant women without HIV-infection, the HBsAg carrier status is not determined. HIV-immunosuppression is accompanied by the prevalence of the immunotolerant phase of CHB (88.9%) with subclinical course without disturbance of pigmentary metabolism and cytolysis increase against the background of a decrease of VL HBV up to the threshold in 83.3% (p<0.01). The inverse weak correlation between the level of CD4 + T-lymphocytes and VL HBV was determined.
 In HIV-negative pregnancies, latent forms of HBV-infection prevail (71.6%). Replicative forms are characterized by a low degree (80.0%) of HBV viremia (p<0.05) with minimal cytolysis in 43.3% of women (p<0.001), which did not change during pregnancy.