Human Immunodeficiency Virus (HIV) and Hepatitis

  • Patricia Herrera
  • J. Paul O’Keefe


Viral hepatitis is caused by five known enterically or parenterally transmitted viruses. The disease can be severe, especially in pregnancy, and chronic liver disease results from infection with two of the five agents. In addition, congenital infection may occur. Likewise, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are becoming increasingly common and are also transmitted vertically. Unique manifestations of HIV infection in women are only recently receiving emphasis in the medical literature. In this chapter the epidemiology, clinical manifestations, treatment, and prevention of these important viral diseases in women and their offspring are reviewed.


Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Human Papilloma Virus Pelvic Inflammatory Disease Human Immunodeficiency Virus Testing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Centers for Disease Control. Delta hepatitis. MMWR. 1984;33:493.Google Scholar
  2. 2.
    Choo Q-L, Kuo G, Weiner AJ, et al. Isolation of a cDNA clone derived from a blood-borne non-A, non-B hepatitis genome. Science. 1989;224:359–362.CrossRefGoogle Scholar
  3. 3.
    Ramalingaswami V, Purcell RH. Waterborne non-A, non-B hepatitis. Lancet. 1988;1:571–3.PubMedCrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control. Hepatitis A among drug users. MMWR. 1988;37:297–300,305.Google Scholar
  5. 5.
    Nobel RL, Kane MA, Reeves SA, et al. Post transfusion hepatitis A in a neonatal intensive care unit. JAMA. 1984;252:2711-S.CrossRefGoogle Scholar
  6. 6.
    Centers for Disease Control. Protection against viral hepatitis. MMWR. 1990;39:1–26.Google Scholar
  7. 7.
    James S, Disaia P, Hammond CP, et al. General medical and surgical diseases in pregnancy. Danforth Obstetrics and Gynecology. 1990;508–509,540–541.Google Scholar
  8. 8.
    Snydman D. Hepatitis in pregnancy. N Engl J Med. 1985;313:1398–1401.PubMedCrossRefGoogle Scholar
  9. 9.
    Oren I, Hershow R, Ben-Porath E, et al. A common source outbreak of fulminant hepatitis B in a hospital. Ann Intern Med. 1989;110:691–698.PubMedGoogle Scholar
  10. 10.
    Sherlock S. Predicting progression of acute type B hepatitis to chronicity. Lancet. 1976; 2:354–356.PubMedCrossRefGoogle Scholar
  11. 11.
    Centers for Disease Control. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. MMWR. 1991;40 (RR13):1–19.Google Scholar
  12. 12.
    Koretz R. Universal prenatal hepatitis B screening. Obstet Gynecol 1989;74;808–814.Google Scholar
  13. 13.
    Reeink HW, Cafever, Scishut, et al. Prevention of chronic HBsAg carrier state in infants of HBsAg positive mothers, by hepatitis B immunoglobulin. Lancet. 1979;1:436–438.CrossRefGoogle Scholar
  14. 14.
    Kane M, Hadler S, Margolis H. Routine prenatal screening for hepatitis B surface antigen. JAMA. 1988;259:408–409.PubMedCrossRefGoogle Scholar
  15. 15.
    Rocca G, Poli G, Gerard P, et al. Family clustering of delta infection. Viral hepatitis and delta infection. New York: Alan R. Liss; 1984:133–137.Google Scholar
  16. 16.
    Rizzetto M, Verma G, Recchia 5, et al. Chronic HBsAg hepatitis with intrahepatic expression of delta antigen. Ann Intern Med. 1983;98:437–441.PubMedGoogle Scholar
  17. 17.
    Dienstag JL. Non-A non-B hepatitis: recognition, epidemiology, and clinical features. Gastroenterology. N Engl J Med. 1983;84:133–137.Google Scholar
  18. 18.
    Davis G, Baiart LA, Schiff ER, et al. Treatment of chronic hepatitis C with recombinant interferon alpha. N Engl J Med. 1989;321: 1501–1506.PubMedCrossRefGoogle Scholar
  19. 19.
    Davis GL, Baiart LA, Schiff ER, et al. Treatment of chronic hepatitis C with recombinant interferon alpha: a multicenter randomized, controlled trial. N Engl J Med. 1989; 321(22): 1501–1506.PubMedCrossRefGoogle Scholar
  20. 20.
    Gust I, Purcell R. Report of a workshop: waterborne non-A, non B hepatitis. J Infect Dis. 1987;156:630–635.PubMedCrossRefGoogle Scholar
  21. 21.
    Ellerbrock T, Rogers M. Epidemiology of human immunodeficiency virus infection in women in the United States. Obstet Gynecol Clin North Am. 1990;17:523–541.PubMedGoogle Scholar
  22. 22.
    Centers for Disease Control. The second 100,000 cases of acquired immunodeficiency syndromeUnited States, June 1981—December 1991. MMWR. 1992;41:28–29.Google Scholar
  23. 23.
    Centers for Disease Control. Update: acquired Immunodeficiency syndromeUnited States, 1981–1990. MMWR. 1991;40:358–363,369.Google Scholar
  24. 24.
    Centers for Disease Control. AIDS in womenUnited States. MMWR. 1990;39:845–846.Google Scholar
  25. 25.
    Marmor M, Weiss LR, Leyden M, et al. Possible female-to-female transmission of human immunodeficiency virus (letter). Ann Intern Med. 1986; 105:969.PubMedGoogle Scholar
  26. 26.
    Monzon OT, Capelian JMB. Female-to-female transmission of HIV (letter). Lancet. 1987; 2:40–41.PubMedCrossRefGoogle Scholar
  27. 27.
    Chu S, Buehler J, Fleming P, et al. Epidemiology of reported cases of AIDS in lesbians, United States; 1980–1989. Am J Public Health. 1990;80:1380–1381.PubMedCrossRefGoogle Scholar
  28. 28.
    Minkoff H, DeHovitz J. Care of women infected with the human immunodeficiency virus. JAMA. 1991;266:2253–2258.PubMedCrossRefGoogle Scholar
  29. 29.
    Allen M. Primary care of women infected with the human immunodeficiency virus. Obstet Gynecol Clin North Am. 1990;17:557–567.PubMedGoogle Scholar
  30. 30.
    Kess S, Bresolin L, Henning J. HIV early care. AMA Physician Guidelines. 1990;1–15.Google Scholar
  31. 31.
    Centers for Disease Control. Recommendations for prophylaxis against Pneumocystis carinii pneumonia for adults and adolescents infected with human immunodeficiency virus. MMWR. 1992;41:1–11.Google Scholar
  32. 32.
    Iman N, Carpenter C, Mayer K, et al. Hierarchical pattern of mucosal Candida infections in HIV-seropositive women. Am J Med. 1990;89:142–146.CrossRefGoogle Scholar
  33. 33.
    Rhoads J, Wright C, Redfield R, et al. Chronic vaginal candidiasis in women with human immunodeficiency virus infection. JAMA. 1987;257(2):3105–3107.PubMedCrossRefGoogle Scholar
  34. 34.
    Hoegsberg B, Abulafia 0, Sedlis A, et al. Sexually transmitted diseases and HIV infection among women with pelvic inflammatory disease. Amer J Obstet Gynecol. 1990;163:1135–1139.Google Scholar
  35. 35.
    Safrin S, Dattel B, Hauer L, et al. Seroprevalence and epidemiologic correlates of human immunodeficiency virus in women with acute pelvic inflammatory disease. Obstet Gynecol. 1990;75:666–670.PubMedGoogle Scholar
  36. 36.
    Centers for Disease Control. Sexually transmitted diseases: therapy guidelines. MMWR. 1989;38:5–15.Google Scholar
  37. 37.
    Peterson HB, Galaid EI. Pelvic inflammatory disease: review of therapeutic options. Rev Infect Dis. 1990;12:S656–664.PubMedCrossRefGoogle Scholar
  38. 38.
    Holmes K, Kreiss J. Heterosexual transmission of human immunodeficiency virus: overview of a neglected aspect of the AIDS epidemic. J Acq Immun Def Synd. 1988;1(6):602–610.Google Scholar
  39. 39.
    Abstracts of The Third International Conference in AIDS. Washington, DC; 1987:25.Google Scholar
  40. 40.
    Pomerantz R, DeLaMonte S, Donegan P, et al. Human immunodeficiency virus infection of the uterine cervix. Ann Intern Med. 1988; 108(3):321–327.PubMedGoogle Scholar
  41. 41.
    Tramont EC. Syphilis in the AIDS era. N Engl Med. 1987;316:1600–1601.CrossRefGoogle Scholar
  42. 42.
    Musher DM, Hamill RJ, Baughn RE. Effect of human immunodeficiency virus in the course of syphilis and on the response to treatment. Ann Intern Med. 1990;113:872–881.PubMedGoogle Scholar
  43. 43.
    Saxon A. Immediate hypersensitivity reactions to beta lactam antibiotics. Ann Intern Med. 1987;107:204–215.PubMedGoogle Scholar
  44. 44.
    Allen M. Primary care of women infected with the human immunodeficiency virus. Obstet Gynecol Clinic North Am. 1990;17(3):557–567.Google Scholar
  45. 45.
    Erlich KS, Jacobson MA, Kochler JE, et al. Foscarnet therapy for severe acyclovir-resistant herpes simplex virus type-Z infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1989;110:710–713.PubMedGoogle Scholar
  46. 46.
    Klug S, Lewandowski C, Merker H, et al. In-vitro and invivo studies on the prenatal toxicity of five virustatic nucleoside analogues in comparison to acyclovir. Arch Toxicol. 1991; 65:283–291.PubMedCrossRefGoogle Scholar
  47. 47.
    Sillman F, Stanek A, Sedlis A. The relationship between human papilloma virus and lower genital neoplasia in immunosuppressed women. Am J Obstet Gynecol. 1984;150:300–308.PubMedGoogle Scholar
  48. 48.
    Maiman M, Fruchter R, Serure, et al. Human immunodeficiency virus infection and cervical neoplasia. Gynecol Oncol. 1990;38:377–382.PubMedCrossRefGoogle Scholar
  49. 49.
    Carpenter C, Mayer K, Stein M, et al. Human immunodeficiency virus infection in North American women: experience with 200 cases and a review of the literature. Medicine. 1991;70(5):307–325.PubMedCrossRefGoogle Scholar
  50. 50.
    Center for Disease Control. Risk for cervical disease in HIV-infected womenNew York City. MMWR. 1990;39:846–849.Google Scholar
  51. 51.
    Maiman M, Tarricone N, Vieira J, et al. Colposcopy evaluation of human immunodeficiency virus-seropositive women. Obstet Gynecol. 1991;78(l):84–88.PubMedGoogle Scholar
  52. 52.
    Senanayake P, Kramer DG. Contraception and the etiology of pelvic inflammatory disease: new perspectives. Am J Obstet Gynecol. 1980;138:852–860.PubMedGoogle Scholar
  53. 53.
    Minkoff H, Nanda D, Menez R. Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS-related complex: follow-up of mothers, children, and subsequently born children. Obstet Gynecol. 1987; 69:285–291.PubMedGoogle Scholar
  54. 54.
    Selwyn P, Schoenbaum E, Davenny K. Prospective study of human immunodeficiency virus infection and pregnancy outcomes in intravenous drug users. JAMA. 1989;261(9): 1289–1294.PubMedCrossRefGoogle Scholar
  55. 55.
    Minkoff H, Willoughby A, Mendez H. Serious infections during pregnancy among women with advanced human immunodeficiency virus infection. Am J Obstet Gynecol. 1990;162:30–34.PubMedGoogle Scholar
  56. 56.
    Sperling R, Stratton P, O’Sullivan M. A survey of zidovudine use in pregnant women with human immunodeficiency virus infection. N Engl J Med. 1992;326:857–861.PubMedCrossRefGoogle Scholar
  57. 57.
    Nanda D. Human immunodeficiency virus infection in pregnancy. Obstet Gynecol Clin North Am. 1990;17(3):617–626.PubMedGoogle Scholar
  58. 57a.
    Baskin CG, Law S, Wenger NK. Sulfadiazine rheumatic fever prophylaxis during pregnancy: does it increase the risk of kernicterus in the newborn? Cardiology. 1980;65:222–225.PubMedCrossRefGoogle Scholar
  59. 58.
    Montgomery AB, Luce JM, Turner J, et al. Aerosolized pentamidine as sole therapy for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome. Lancet. 1987;1:480–482.CrossRefGoogle Scholar
  60. 59.
    Minkoff H. Care of pregnant women infected with human immunodeficiency virus. JAMA. 1987;258(19):2714–2712.PubMedCrossRefGoogle Scholar
  61. 60.
    MacGregor S. Human immunodeficiency virus infection in pregnancy. Clin Perinatol. 1991; 18(l):33–50.PubMedGoogle Scholar
  62. 61.
    MacDonald, Ginzburg H, Bolan J. HIV infection in pregnancy: epidemiology and clinical management. J Acq Immun Def Synd. 1991;4(2): 100–108.Google Scholar
  63. 62.
    Sprechers S, Soumenkoff G, Puissant F, et al. Vertical transmission of HIV in 15-week fetus (letter). Lancet. 1986;2:288.CrossRefGoogle Scholar
  64. 63.
    Rubinstein A, Bernstein L. The epidemiology of pediatric acquired immunodeficiency syndrome. Clin Immunol Immunopathol. 1986; 40:115–121.PubMedCrossRefGoogle Scholar
  65. 64.
    Newell ML, Dunn D, Peckham CS, et al. Risk factors for mother to child transmission of HIV-1. Lancet. 1992;339:1007–1012.CrossRefGoogle Scholar
  66. 65.
    Blanche S, Rourioux C, Moscato ML, et al. A prospective study of infants born to women seropositive for human immunodeficiency virus type 1.N Engl J Med. 1989;320:1643–1648.PubMedCrossRefGoogle Scholar
  67. 66.
    Lepage P, Van de Perre P, Caraal M. Transmission of HIV from mother to child. Lancet. 1987;2:400.PubMedCrossRefGoogle Scholar
  68. 67.
    Colbunders RL, Kapita B, Nekwer W, et al. Breast-feeding and transmission of HIV. Lancet. 1988;2:1487.CrossRefGoogle Scholar
  69. 68.
    Logan S. Newell ML, Ades T, et al. Breastfeeding and HIV infection. Lancet. 1988; 1: 1346.CrossRefGoogle Scholar
  70. 69.
    Hira SK, Mangrola UG, Mwale C. Apparent vertical transmission of human immunodeficiency virus type 1 by breast feeding in Zambia. J Pediatr. 1990;117:421–430.PubMedCrossRefGoogle Scholar
  71. 70.
    Mendez H, Jule J. Care of the infant born exposed to human immunodeficiency virus. Obstet Gynecol Clin North Am. 1990;17:637–649.PubMedGoogle Scholar
  72. 71.
    Oxtoby MJ. Human immunodeficiency virus and other viruses in human milk: placing the issue in broader perspective. Pediatr J Infect Dis. 1988;7:825.Google Scholar
  73. 72.
    Minkoff H. Care of Pregnant women infected with human immunodeficiency Virus. JAMA. 1987;258:2714–2717.PubMedCrossRefGoogle Scholar
  74. 73.
    Rogers M, Ou C, Rayfield M, et al. Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers. N Engl J Med. 1989; 320:1649–1654.PubMedCrossRefGoogle Scholar
  75. 74.
    Comeau AM, Harris JA, Mcintosh K. Polymerase chain reaction in detecting HIV infection among seropositive infants: relation to clinical status and age and to results of other assays. J Acq Immun Def Synd. 1992;5:27–278.CrossRefGoogle Scholar
  76. 75.
    Weiblen BJ, Lee FK, Cooper ER, et al. Early diagnosis of HIV infection in infants by detection of Ig A HIV antibodies. Lancet. 1990; 335:988–990.PubMedCrossRefGoogle Scholar
  77. 76.
    Quinn T, Kline R, Halsey N, et al. Early diagnosis of perinatal HIV infection by detection of viral-specific Ig A antibodies. JAMA. 1991;266(24):3439–3442.PubMedCrossRefGoogle Scholar
  78. 77.
    Seiff LB, Wright EC, Zimmerman HJ. Type B hepatitis after needlestick exposure: prevention with hepatitis B immunoglobulin: final report of the Veterans Administration cooperative study. Ann Intern Med. 1978;88:285–93.Google Scholar
  79. 78.
    McCray E. The cooperative needlestick surveillance group. Occupational risk of acquired immunodeficiency syndrome among health care workers. N Engl J Med. 314:1127–1132.Google Scholar
  80. 79.
    Hepatitis C in hospital employees with needlestick injuries. Ann Intern Med. 1991; 115:367–369.Google Scholar
  81. 80.
    Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus and other blood-borne pathogens in health care settings. MMWR. 1988;37:377–388.Google Scholar
  82. 81.
    Henderson DK, Fahey BJ, Willy M, et al. Riskfor occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation. Ann Intern Med. 1990;113:740–746.PubMedGoogle Scholar
  83. 82.
    Recommendations for prevention of HIV transmission in health care settings. MMWR. 1987;36–25:15–185.Google Scholar
  84. 83.
    Department of Labor Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens. Federal Register. 1991;56:64175–64182.Google Scholar
  85. 84.
    Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR. 1991;40(RR-8): 1–9.Google Scholar
  86. 85.
    Centers for Disease Control. Possible transmission of human immunodeficiency virus to a patient during invasive dental procedure. MMWR. 1990;39:489–495.Google Scholar

Copyright information

© Springer-Verlag New York, Inc. 1993

Authors and Affiliations

  • Patricia Herrera
  • J. Paul O’Keefe

There are no affiliations available

Personalised recommendations