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Original research
Impact of maternal HIV–HBV coinfection on pregnancy outcomes in an underdeveloped rural area of southwest China
  1. Chunlin Li1,2,3,
  2. Yu Yang1,2,3,
  3. Yingjian Wang1,2,3,
  4. Shurong Dong1,2,3,
  5. Ya Yang1,2,3,
  6. Ying Shi1,2,3,
  7. Linhan Li1,2,3,
  8. Feng Jiang1,2,3,
  9. Yue Chen4,
  10. Qingwu Jiang1,2,3,
  11. Yibiao Zhou1,2,3
  1. 1 Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
  2. 2 Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
  3. 3 Centre for Tropical Disease Research, Fudan University, Shanghai, China
  4. 4 School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  1. Correspondence to Professor Yibiao Zhou, Fudan University, Shanghai 200032, China; z_yibiao{at}


Objectives Our objective was to determine the impact of maternal HIV–hepatitis B virus (HBV) coinfection on pregnancy outcomes.

Methods The current study was conducted in a county of Yi Autonomous Prefecture in southwest China. Data were abstracted from hospitalisation records, including maternal and infant information. The seroprevalences of HIV and HBV infections and HIV–HBV coinfection were determined and the impact of maternal HIV–HBV coinfection on adverse pregnancy outcomes was assessed using logistic regression analysis. A treatment effects linear regression model was also applied to examine the effect of HBV, HIV or coinfection to quantify the absolute difference in birth weight from a reference of HBV–HIV negative participants.

Results A total of 13 198 pregnant women were included in our study, and among them, 99.1% were Yi people and 90.8% lived in rural area. The seroprevalences of HIV and HBV infections and HIV–HBV coinfection were 3.6% (95% CI: 3.2% to 3.9%), 3.2% (95% CI: 2.9% to 3.5%) and 0.2% (95% CI: 0.1% to 0.2%) among the pregnant women, respectively. Maternal HIV–HBV coinfection was a risk factor for low birth weight (adjusted OR (aOR)=5.52, 95% CI: 1.97 to 15.40). Compared with the HIV mono-infection group, the risk of low birth weight was significantly higher in the HIV–HBV coinfection group (aOR=3.62, 95% CI: 1.24 to 10.56). Maternal HIV infection was associated with an increased risk of low birth weight (aOR=1.90, 95% CI: 1.38 to 2.60) and preterm delivery (aOR=2.84, 95% CI: 1.81 to 4.47). Perinatal death was more common when mothers were infected with HBV (aOR=2.85, 95% CI: 1.54 to 5.26).

Conclusions The prevalence of HIV infection was high among pregnant women of the Yi region. Both HIV and HBV infections might have adverse effects on pregnancy outcomes. Maternal HIV–HBV coinfection might be a risk factor for low birth weight in the Yi region, which needs to be confirmed.

  • HIV
  • HBV
  • coinfection
  • low birth weight
  • preterm delivery
  • perinatal death

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  • Handling editor Anna Maria Geretti

  • Contributors CL participated in the conception and design of study, data collection, statistical analysis and interpretation of the analysis outcome and the preparation of the manuscript. YZ, YC and QJ participated in the interpretation of the data and in the critical review and revision of the manuscript draft. YY, YY, SD, YW, LL, YS and FJ performed data collection for the study and participated in the preparation of the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by internal funding.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This procedures of this study were reviewed and approved by the Ethical Review Committee of Fudan University, Shanghai, China. The approval number is IRB#2017-TYSQ-10–1.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.