1HBV, HCV or syphilis coinfection in HIV-1-infected pregnant women in Caracas,

2Venezuela: a 5-years retrospective study

4Yoel García1,a, Francisco Ureña1,a, Fhabián S. Carrión-Nessi2,3, Sol Díaz2,4, Atahualpa Ávila2,4,

5Diana C. Freitas-De Nobrega2, Martín Carballo1, María E. Landaeta1, David A. Forero-Peña1,2*

71 Infectious Diseases Department, Caracas University Hospital, Caracas, Venezuela

82 Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela

93 “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar

10 Nucleus, Ciudad Bolivar, Venezuela

114 “Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela

12a These authors have contributed equally to this work and shared joint first authorship

13

14* Corresponding author: David Alberto Forero-Peña. Address: Infectious Diseases

15 Department, Caracas University Hospital, San Pedro parish, Libertador municipality, Caracas,

16 Capital District, Venezuela. Telephone: +58 (424) 954-8706. E-mail: vacter.cv@gmail.com

17
18Abstract

19Background: a.

20Methods: a.

21Results: a.

22Conclusions: a.

23Keywords: a.

24

25Introduction

26The human immunodeficiency virus (HIV) continues to be one of the world's biggest public

27health problems.1 An estimated 38 million people were living with HIV worldwide in 2019, of

28which more than half (52.9% ) were women. 2 The incidence of HIV infections among women of

29reproductive age (15–49 years) is high, with 5.2 million cases diagnosed between 2010 and

302015,3 and 660,000 cases diagnosed in 2019 alone. 2 Most women HIV-infected people of

31reproductive age come from low- and middle-income countries, and in 2019 it was estimated that

32121,000 (8.6%) of them lived in Latin America and the Caribbean. In Venezuela, 110,000 people

33are living with HIV, of which 38,000 are women of reproductive age.2

34In HIV-infected pregnant women, an index of suspicion should be established for coinfection
4,5
35with hepatitis B (HBV) or C (HCV) viruses and syphilis, since they share transmission routes,

36and the Immunodeficiency status can promote the chronicity of HBV infection, as well as
37accelerate the development of end-stage liver disease from HCV infection.6,7 However, it remains

38controversial whether HBV or HCV have a direct impact on the HIV disease progression. 8,9 In

39the case of syphilis, maternal infection can also lead to adverse outcomes during delivery, such

40as prematurity, low birth weight, severe neonatal infection, or neonatal death.10-13

41Unfortunately, few studies have addressed HBV, HCV and/or syphilis co-infection in HIV-

42infected pregnant women, even more so in Venezuela. This study aimed to determine the

43prevalence of coinfection by HBV, HCV and syphilis in HIV-infected pregnant women at the

44Hospital Universitario de Caracas, Venezuela.

45

46Methods

47Study design and participants

48A retrospective study was carried out in all HIV-infected pregnant women who consulted at the

49Infectious Diseases Department of Caracas University Hospital, Caracas, Venezuela, between

502014 and 2018. A systematic review of the medical records of the patients who started ART was

51carried out, they were administered benzathine penicillin, and they were followed up.

52

53Ethical permission
54The study protocol was reviewed and approved by the National Center for Bioethics (CENABI)

55of Venezuela. The information was collected according to the Helsinki Convention and the

56Venezuelan regulations for this type of research.

57

58Statistical analyses

59

60

61Results

62Un total de 156 mujeres embarazadas infectadas con el VIH fueron incluidas en el estudio. La

63media de edad fue de 27 (DE –desviación estándar– 6; rango de 14 a 42) años, la mayoría eran

64amas de casa (n = 117; 75%). Solo 50 (32,1%) pacientes tenían un suficiente control prenatal

65para su edad gestacional. Entre los antecedentes ginecobstétricos, 88 (56,4%) pacientes tuvieron

66entre una y tres gestaciones previas, y 46 (29,5%) tuvieron un aborto previo. La media de días de

67hospitalización fue de 4,51 (DE 4,72) días (Tabla 1).

68Ciento nueve (69,9%) pacientes disponían de resultados de carga viral, de los cuales solo 60

69(35,8%) tenían carga viral detectable (Figura 1). Con respecto a la prevalencia del VHB, del

70VHC y la sífilis en mujeres embarazadas infectadas con el VIH, el 35.5% (n = 55/156) de las

71pacientes se realizó el test para el VHB, donde solo el 9.1% (n = 5/55) resultó positivo; 40.4% (n

72= 63/156) se realizó el test para el VHC, donde solo el 3.2% (n = 2/63) resultó positivo; mientras
73que la mayoría (n = 134/156; 85,9%) de las pacientes se realizó el test del VDRL,

74evidenciándose que el 8.2% (n = 10/134) resultó positivo (Figura 2).

75Con respecto al desenlace del embarazo, el 4,5% (n = 7/156) de las pacientes abortó, el 16% (n =

7625/156) tuvo un recién nacido con prematuridad y el 7,1% (n = 11/156) tuvo mortinato (Figura

773).

78

79Discussion

80

81

82References

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