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.
References
Boyko VO. Epidemiological characteristic of clinical and laboratory features of chronic viral hepatitis B and C in pregnant women. Profilaktichna Medicina. 2010; 4 (12): 23-25.
Shadrin OG. Chernega NF. Dukareva SV. Basaraba NM. Mohilniy OI. Clinical and paraclinical features of the course of hepatitis B and C in infants with perinatal infection.Neonatologiya, hirurgiya ta perinatalna medicina. 2014; IV, 2 (12): 96-100.
Kuzmin VN. Specificity of the therapy of viral hepatitis B in pregnant women. Zdorovye zhenshchiny. 2009; 10 (46): 114-116.
Maevskaya MV. Hepatitis B and reproductive health. Rossiyskiy zhurnal Gastroenterologii, Gepatologii, Koloproktologii. 2009; (5): 4-9.
Pereverten LYu, Matiushkina LS, Rachkova EV. Clinical and laboratory characteristics of chronic viral hepatitis in pregnant women. Sovremennye naukoemkiye tekhnologii. 2014; 12(1): 66-70.
Chuikova KI, Kovaleva TA, Evtushenko ID. Chronic viral hepatitis B and C during pregnancy (the strategy to minimize the risk of the infection vertical transmission). Lechashchiy vrach. 2009; (11): 68-71.
Navabakhsh B, Mehrabi N, Estakhri A, Mohamadnejad M, Poustchi H. Hepatitis B Virus Infection during Pregnancy: Transmission and Prevention. Middle East Journal of Digestive Diseases. 2001; 3 (2): 92-102.
Jonas MM. Hepatitis B and pregnancy: an underestimated issue. Liver International. 2009; 29 (1): 133-139. DOI: https://doi.org/10.1111/j.1478-3231.2008.01933.x [PMid:19207977]
Han J-R, Xu C-L, Zhao W, Yang Y-F. Management of chronic hepatitis B in pregnancy. World Journal Gastroenterology. 2012; 18 (33): 4517-4521. DOI: https://doi.org/10.3748/wjg.v18.i33.4517 [PMid:22969224 PMCid:PMC3435776]
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