HIV-Hepatitis C Coinfection Increases Preterm Birth Risk in Pregnant Women

Hepatitis C virus (HCV) coinfection increases the risk of preterm birth in women with HIV four-fold to those with lone HIV, according to a new study.

Justyna Kowalska, MD, PhD, of the Hospital for Infectious Diseases and the Medical University of Warsaw, told MD Magazine® the study aimed to give greater clarity to the roles of HCV and HIV in the pregnancies of coinfected women.

“It is well recognized in [the] mono-HCV infected population that HCV replication affects intrauterine fetus growth and can also lead to preterm delivery,” she said.

HIV itself is not associated with preterm delivery, though antiretroviral therapy is. “However, most large HIV studies do not include HCV replication as a potential risk factor,” Kowalska said.

The HIV outpatient clinic at Kowalska’s hospital, however, provided a large enough patient population to study the issue of HIV/HCV coinfection more closely. The researchers looked at data from 2006 to 2017, finding 187 pregnancies.

After excluding pregnancies that ended in abortions and pregnancies where the outcome or combination ART status was unknown, they were left with 159 applicable pregnancies. Of those, 19 (11.9%) concluded with a preterm delivery. Among the women included in the study, 27% had chronic HCV coinfection.

About half (52%) of patients were taking combination ART at the time they became pregnant, and 1 in 5 had a detectable viral load when they went into labor. Kowalska noted that initiating ART prior to pregnancy has been associated with a higher risk of preterm birth, though she said that finding was not replicated in their study, likely due to the small sample size.

The scientists analyzed the data to determine individual causes, after which the only factor associated with increased odds of a preterm birth was HCV coinfection. Kowalska said larger studies are needed to draw broad conclusions, but she said one key conclusion from her study is that HCV needs to be considered as a factor whenever researchers study preterm births.

In the meantime, Kowalska urged physicians to take HCV very seriously in pregnant patients.

“All women with confirmed HCV (irrespective of HIV status) should be informed about the risk it brings (risk of transmission to both baby and sexual partners, and risk of unfavorable pregnancy outcome),” she said. “They should be informed about HCV treatment options and if they plan pregnancy they should be prioritized in HCV treatment programs.”

Kowalska noted that new guidelines from the European AIDS Clinical Society published last month align with the findings of her study.

Those guidelines state that in women of childbearing age, HCV treatment should be initiated “prior to conception because of the lack of safety data in pregnancy and to reduce the risk of [mother-to-child transmission] of HCV.”

The study, “HCV co-infection is a strong risk factor for preterm birth among HIV-positive women on cART: data from HIV Out-Patient Clinic in Warsaw,” was presented at the 2018 International Congress on Drug Therapy in HIV Infection.

 
This article was originally published by MD Magazine.




Stay up to date on the latest news in specialty pharmacy by getting Specialty Pharmacy Times in your mailbox or inbox for free!

Click here to sign up for free for the bi-monthly Specialty Pharmacy Times print journal delivered to your address.

Click here to sign up for our email newsletters delivered every Monday, Wednesday, and Friday, in addition to breaking news alerts.

Click here to follow us on Facebook. 

Click here to follow us on Twitter. 

Click here to join our LinkedIn group. 


Most Popular

Related Articles

Bodily fluids may serve as vectors for transmission for transmitting hepatitis C virus RNA in patients with a high viral load.
Detecting hepatitis C RNA in peripheral blood mononuclear cells or liver cells in patients who are negative for viral RNA raises questions about the risk of transmission to other individuals.
Early detection is vital to more patients with hepatitis C virus being eligible for increasingly efficient direct-acting antiviral treatment options.
Company Profile >
Contributors >
Industry Guide >
Market News >
Peer Exchange >
Conferences >
Subscribe >
Specialty Times Resources
About Us
Advertise
Careers
Contact Us
Terms & Conditions
Privacy
MJH Associates >
Pharmacy Times
OTCGuide
American Journal of Managed Care
Cure
MD Magazine
ONCLive
Targeted Oncology
Physicians' Education Resource
Pharmacy & Healthcare Communications, LLC
2 Clarke Drive
Suite 100
Cranbury, NJ 08512
P: 609-716-7777
F: 609-716-4747

Copyright Specialty Pharmacy Times 2006-2018
Pharmacy & Healthcare Communications, LLC. All Rights Reserved.
 

$vacMongoViewPlus$