RESUMO
OBJECTIVES: The aim of the study was to investigate the prevalence of and risk factors for hepatitis C or B virus (HCV or HBV) coinfection among HIV-infected pregnant women, and to investigate their immunological and virological characteristics and antiretroviral therapy use. METHODS: Information on HBV surface antigen (HBsAg) positivity and HCV antibody (anti-HCV) was collected retrospectively from the antenatal records of HIV-infected women enrolled in the European Collaborative Study and linked to prospectively collected data. RESULTS: Of 1050 women, 4.9% [95% confidence interval (CI) 3.6-6.3] were HBsAg positive and 12.3% (95% CI 10.4-14.4) had anti-HCV antibody. Women with an injecting drug use(r) (IDU) history had the highest HCV-seropositivity prevalence (28%; 95% CI 22.8-35.7). Risk factors for HCV seropositivity included IDU history [adjusted odds ratio (AOR) 2.92; 95% CI 1.86-4.58], age (for > or =35 years vs. <25 years, AOR 3.45; 95% CI 1.66-7.20) and HBsAg carriage (AOR 5.80; 95% CI 2.78-12.1). HBsAg positivity was associated with African origin (AOR 2.74; 95% CI 1.20-6.26) and HCV seropositivity (AOR 6.44; 95% CI 3.08-13.5). Highly active antiretroviral therapy (HAART) use was less likely in HIV/HCV-seropositive than in HIV-monoinfected women (AOR 0.34; 95% CI 0.20-0.58). HCV seropositivity was associated with a higher adjusted HIV RNA level (+0.28 log(10) HIV-1 RNA copies/mL vs. HIV-monoinfected women; P=0.03). HIV/HCV-seropositive women were twice as likely to have detectable HIV in the third trimester/delivery as HIV-monoinfected women (AOR 1.95; P=0.049). CONCLUSIONS: Although HCV serostatus impacted on HAART use, the association between HCV seropositivity and uncontrolled HIV viraemia in late pregnancy was independent of HAART.
Assuntos
Infecções por HIV/complicações , Hepatite B Crônica/epidemiologia , Hepatite C Crônica/epidemiologia , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Estudos de Coortes , Europa (Continente)/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Antígenos de Superfície da Hepatite B/sangue , Hepatite B Crônica/complicações , Hepatite B Crônica/tratamento farmacológico , Anticorpos Anti-Hepatite C/sangue , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Humanos , Modelos Logísticos , Gravidez , Prevalência , RNA Viral/sangue , Fatores de Risco , Adulto JovemRESUMO
An intense five-month radiotelegraph training was chosen as a model of prolonged mental fatigue. The state correction was carried out by a fortnight administration of placebo and nootropic piracetam (daily dosage 1.2 g). The efficiency of pharmacological correction was estimated with the help of experimental psychological and psychophysiological methodics. The data processing was made by means of multivariate correlative analysis with automatic selection of essential signs and factor analysis. The data obtained during this study contributed for a more precise formulation of a notion "health status", which must include sociopsychological, intellectual physiological components, as well as self-consciousness.