Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study

  • Tung-Che Hung Department of Infectious Diseases, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
  • Li-Cheng Lu Department of Gynecology and Obstetrics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan
  • Mei-Hui Lin Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
  • Yu-Chia Hu Department of Gynecology and Obstetrics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan
  • Chien-Yu Cheng Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
  • Shu-Hsing Cheng Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
  • Chien-Yu Lee Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
Keywords: pregnancy, fetus, HIV, AIDS, antiretroviral therapy

Abstract

Introduction: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care.

Methodology: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well.

Results: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV.

Conclusions: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.

Author Biography

Shu-Hsing Cheng, Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

Director, department of infectious diseases

Published
2020-08-31
How to Cite
1.
Hung T-C, Lu L-C, Lin M-H, Hu Y-C, Cheng C-Y, Cheng S-H, Lee C-Y (2020) Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study. J Infect Dev Ctries 14:901-907. doi: 10.3855/jidc.11745
Section
Original Articles