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HCV–HIV coinfected pregnant women: data from a multicentre study in Italy

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Abstract

Purpose

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.

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Acknowledgments

We thank Cosimo Polizzi and Alessandra Mattei of the Istituto Superiore di Sanità in Rome, Italy, for providing technical secretariat for this study. No compensation was received for this contribution. We also thank Dr. Nadia Zanchetta, from the U.O.C. of Clinical Microbiology, Virology and Bioemergency diagnostics, A.O. L. Sacco, Milan, for helpful support. Presented in part at the ICAR 2015 Conference—VII Italian conference on AIDS and Retroviruses, Riccione, 2015, May 17–19, Italy.

The Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy

Participants: M. Ravizza, E. Tamburrini, F. Mori, P. Ortolani, E.R. dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, F. Vichi, B. Del Pin, E. Pinter, E. Anzalone, R. Marocco, C. Mastroianni, V.S. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, M. Zaramella, B. Mariani, G. Natalini Raponi, G. Guaraldi, G. Nardini, C. Stentarelli, B. Beghetto, A.M. Degli Antoni, A. Molinari, M.P. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, S. Coletto, F. Di Nello, C. Madia, G. Placido, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, F. Sabbatini, D. Francisci, L. Bernini, P. Grossi, L. Rizzi, S. Alberico, G. Maso, M. Airoud, G. Soppelsa, A. Meloni, M. Dedoni, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Bordoni Vicini, K. Luzi, A. Spinillo, M. Roccio, A. Vimercati, A. Miccolis, A. De Gennaro, B. Guerra, F. Cervi, C. Puccetti, E. Margarito, M. Contoli, M.G. Capretti, C. Marsico, G. Faldella, M. Sansone, P. Martinelli, A. Agangi, A. Capone, G.M. Maruotti, C. Tibaldi, L. Trentini, T. Todros, G. Masuelli, V. Frisina, I. Cetin, T. Brambilla, V. Savasi, C. Personeni, C. Giaquinto, M. Fiscon, R. Rinaldi, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, O. Genovese, C. Cafforio, C. Pinnetti, G. Liuzzi, V. Tozzi, P. Massetti, A.M. Casadei, A.F. Cavaliere, M. Cellini, G. Castelli Gattinara, A.M. Marconi, S. Dalzero, V. Sacchi, M. Ierardi, C. Polizzi, A. Mattei, M.F. Pirillo, R. Amici, C.M. Galluzzo, S. Donnini, S. Baroncelli, M. Floridia.

Project coordinators: M. Floridia, M. Ravizza, E. Tamburrini.

Pharmacokinetics: P. Villani, M. Cusato.

Advisory Board: A. Cerioli, M. De Martino, P. Mastroiacovo, M. Moroni, F. Parazzini, E. Tamburrini, S. Vella.

SIGO-HIV Group National Coordinators: P. Martinelli, M. Ravizza.

Author information

Authors and Affiliations

  1. Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy

    S. Baroncelli, M. F. Pirillo, R. Amici & Marco Floridia

  2. Department of Infectious Diseases, Catholic University, Rome, Italy

    E. Tamburrini

  3. Department of Paediatrics, Catholic University, Rome, Italy

    O. Genovese

  4. Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy

    M. Ravizza, S. Dalzero & V. Sacchi

  5. Department of Paediatrics, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy

    A. Maccabruni

  6. Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, Universiy of Turin, Turin, Italy

    G. Masuelli

  7. Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy

    G. Guaraldi

  8. I.N.M.I. Lazzaro Spallanzani, Rome, Italy

    G. Liuzzi & C. Pinnetti

  9. Department of Paediatrics, Luigi Sacco Hospital and University of Milan, Milan, Italy

    V. Giacomet

  10. Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy

    A. Degli Antoni

  11. Department of Obstetrics and Gynaecology and Policlinic Hospital, University of Bari, Bari, Italy

    A. Vimercati

Authors
  1. S. Baroncelli
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  2. M. F. Pirillo
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  3. R. Amici
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  4. E. Tamburrini
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  5. O. Genovese
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  6. M. Ravizza
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  7. A. Maccabruni
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  8. G. Masuelli
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  9. G. Guaraldi
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  10. G. Liuzzi
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  11. C. Pinnetti
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  12. V. Giacomet
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  13. A. Degli Antoni
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  14. A. Vimercati
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  15. S. Dalzero
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  16. V. Sacchi
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  17. Marco Floridia
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Corresponding author

Correspondence to Marco Floridia.

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Conflict of interest

None to declare. None of the authors has a commercial or other association, financial interest, activity, relationship or association that might pose a conflict of interest. The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

This work was supported by public research grants (ref.: H85E08000200005) from the Italian Medicines Agency (AIFA). No funding was received for this work from any of the following organisations: National Institutes of Health (NIH); Wellcome Trust; and the Howard Hughes Medical Institute (HHMI).

Details of ethics approval

Obtained on September 28, 2001 from the Ethics Committee of the I.N.M.I. Lazzaro Spallanzani in Rome (ref. deliberation n. 578).

Additional information

On behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy.

The members of the “The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy” are given in Acknowledgments.

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Baroncelli, S., Pirillo, M.F., Amici, R. et al. HCV–HIV coinfected pregnant women: data from a multicentre study in Italy. Infection 44, 235–242 (2016). https://doi.org/10.1007/s15010-015-0852-0

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  • DOI: https://doi.org/10.1007/s15010-015-0852-0

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