Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern brazil: high rate of intraepithelial cervical lesions

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 107; no. 2; pp. 205 - 210
• Main Authors: Tornatore, Michele, Gonçalves, Carla Vitola, Bianchi, Mônica Steigleder, Germano, Fabiana Nunes, Garcés, Alzira Xavier, Soares, Marcelo Alves, Machado, Elizabeth Stankiewicz, de Martinez, Ana Maria Barral
• Format: Journal Article
• Language: English
• Published: Brazil Fundação Oswaldo Cruz, Fiocruz 01-03-2012; Instituto Oswaldo Cruz, Ministério da Saúde; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Brazil - epidemiology; cervical carcinoma; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; co-infections; Cohort Studies; Coinfection - epidemiology; Coinfection - virology; Cross-Sectional Studies; DNA, Viral - blood; Female; HIV Infections - epidemiology; HIV Infections - virology; HIV-1; Humans; Infant, Newborn; Papillomavirus Infections - epidemiology; Papillomavirus Infections - virology; PARASITOLOGY; Pregnancy; pregnancy - HIV-1 - co-infections - STDs - cervical carcinoma; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - pathology; Pregnancy Complications, Infectious - virology; Pregnancy Outcome; Prevalence; STDs; TROPICAL MEDICINE; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Dysplasia - pathology; Uterine Cervical Dysplasia - virology; Brazil; HIV-1; co-infections; STDs; pregnancy; cervical carcinoma
• ISSN: 1678-8060; 0074-0276; 1678-8060; 0074-0276
• DOI: 10.1590/S0074-02762012000200009

Human immunodeficiency virus type 1 (HIV-positive) pregnant women
require specific prophylactic and therapeutic approaches. The efficacy
of established approaches is further challenged by co-infection with
other sexually transmitted diseases (STDs). The objective of this study
was to determine the prevalence of co-infections in pregnant women
infected with different HIV-1 subtypes and to relate these findings,
together with additional demographic and clinical parameters, to
maternal and infant outcomes. Blood samples from pregnant women were
collected and tested for syphilis, hepatitis B virus (HBV) and
hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was
evaluated by the presence of alterations in the cervical epithelium
detected through a cytopathological exam. Medical charts provided
patient data for the mothers and children. Statistical analyses were
conducted with STATA 9.0. We found a prevalence of 10.8% for HCV, 2.3%
for chronic HBV, 3.1% for syphilis and 40.8% for HPV. Of those
co-infected with HPV, 52.9% presented high-grade intraepithelial
lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1'
and 5' and Capurro scores were similar between co-infected and
non-co-infected women. The presence of other STDs did not impact
maternal and concept outcomes. More than half of the patients
presenting cervical cytology abnormalities suggestive of HPV had
high-grade squamous intraepithelial lesions or cervical cancer,
evidencing an alarming rate of these lesions.