HBV coinfection is associated with reduced CD4 response to antiretroviral treatment in pregnancy

Marco Floridia, Giulia Masuelli, Enrica Tamburrini, Arsenio Spinillo, Giuliana Simonazzi, Giovanni Guaraldi, Anna Maria Degli Antoni, Pasquale Martinelli, Vincenzo Portelli, Serena Dalzero, Marina Ravizza

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the impact of Hepatitis B virus (HBV) coinfection on response to antiretroviral treatment in pregnant women with HIV. Methods: Retrospective analysis of a large case series of pregnant women with HIV in Italy; outcome measures were CD4 changes, HIV viral load, and main pregnancy outcomes (preterm delivery, low birthweight, intrauterine growth restriction, mode of delivery, and major birth defects). Results: Rate of HBV coinfection among 1462 pregnancies was 12.0%. Compared to the HBV-uninfected, HBV-coinfected women had a significantly lower median CD4 cell gain between first and third trimester (26.5 vs. 60 cells/mm3, p = 0.034), with similar rate of undetectable (<50 copies/ml) HIV-RNA at third trimester (70.5% vs. 65.2%, p = 0.229), and no differences in all the main maternal and infant outcomes. A multivariable linear regression analysis identified four variables significantly and independently associated with a lower CD4 response in pregnancy: HBV coinfection (–35 cells/mm3), being on antiretroviral treatment at conception (–59.7 cells/mm3), AIDS status (–59.8 cells/mm3) and higher first CD4 levels in pregnancy (–0.24 cells per unitary CD4 increase). Conclusions: HBV coinfection had no adverse influence on the main pregnancy outcomes or on HIV viral load suppression in late pregnancy but was associated with a significantly reduced CD4 response in pregnancy. This effect might have clinical relevance, particularly in women with advanced immune deterioration.

Original languageEnglish
Pages (from-to)54-59
Number of pages6
JournalHIV Clinical Trials
Volume18
Issue number2
DOIs
Publication statusPublished - Mar 4 2017

Keywords

  • Antiretroviral treatment
  • CD4 response
  • HBV
  • HIV
  • HIV viral load
  • Pregnancy
  • Pregnancy outcomes
  • Preterm delivery

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Floridia, M., Masuelli, G., Tamburrini, E., Spinillo, A., Simonazzi, G., Guaraldi, G., Degli Antoni, A. M., Martinelli, P., Portelli, V., Dalzero, S., & Ravizza, M. (2017). HBV coinfection is associated with reduced CD4 response to antiretroviral treatment in pregnancy. HIV Clinical Trials, 18(2), 54-59. https://doi.org/10.1080/15284336.2016.1276312