HIV合并HBV感染孕妇HAART治疗对妊娠结局和母婴阻断的影响

目的:探究人类免疫缺陷病毒(HIV)高活性抗病毒疗法(HAART)治疗乙肝病毒(HBV)合并HIV感染孕妇妊娠结局和母婴阻断效果。方法:选取2017年1月-2019年1月本院产前检查并分娩的HIV感染孕妇68例,其中合并HBV感染32例(HBV/HIV组),单纯HIV感染(HIV组),两组孕妇均使用替诺福韦加拉米夫定加洛匹那韦/利托那韦进行HAART治疗。分析HAART治疗前后两组HIV病毒感染相关指标和肝功能、妊娠不良事件、HIV和HBV母婴阻断效果。结果:两组治疗后,HIV DNA拷贝数、CD4+T细胞计数均得到有效改善,但组间无差异(P>0.05);HBV/HIV组肝功能指标、HBsAg阳性率均降低;分娩的早产、流产、低体重新生儿等妊娠不良事件发生率两组无差异(P>0.05),但新生儿Apgar评分≤7分比例HBV/HIV组(31.3%)高于HIV组(11.1%)(P<0.05),HIV和HBV的母婴阻断效果两组相当均达到90%以上。结论:HBV合并HIV感染采用HAART治疗未降低治疗效果,但分娩新生儿有轻度窒息的可能,应引起临床注意。

The influence of high-activity antiviral therapy on pregnancy outcomes and maternal-to-child block effect of HIV-positive pregnant women with coinfection of HBV

Objective:To explore the influence of high-activity antiviral therapy(HAART)on pregnancy outcomes and maternal-to-child block effect of HIV-positive pregnant women with coinfection of HBV.Methods:68 HIV-positive pregnant women were included and were divided in group A(32 women with coinfection of HBV)and group B(36 women without coinfection of HBV)from January 2017 to January 2019.HAART,such as tenofovir,lamivudine and lopinavir/ritonavir,were given the women in both groups.The HIV infection-related indicators and liver function,adverse events during pregnancy,and mother-to-child blocking effect of HIV and HBV of women in the two groups before and after HAART were analyzed.Results:After treatment,HIV DNA copy number and CD4+T cell count of women in both groups had improved significantly,but which had no significant differences between the two groups(P>0.05).The liver function index and HBsAg positive rate of women in group A had decreased significantly.There were no significant differences in the incidences of adverse pregnancy events,such as preterm birth and miscarriage rates of women,and low birth weight of newborns between the two groups(P>0.05),but the proportion of Apgar score≤7 points of newborns in group A(31.3%)was significant higher than that(11.1%)of newborns in group B(P<0.05),the mother-to-child blocking effect of HIV of women in the two groups was similar,which were both over 90%.Conclusion:HAART for women with co-infection of HIV and HBV will not decrease therapeutic effect,but it maybe increase the possibility of mild asphyxia of newborn,so it is should be paid more attention to in clinic.