Human Immunodeficiency Virus and Hepatitis B Virus Co-infection in Pregnancy: A Review

This article presents an overview of the global consensus of the management of pregnant women living with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infection. We summarise findings from the most recent and relevant literature on this topic with a focus on epidemiology, obstetric and pharmacological management and neonatal care.

Guidelines have been revised to reflect the most recent evidence published on the safety and efficacy of both dolutegravir and tenofovir alafenamide in pregnancy. There are encouraging data to suggest that obstetric outcomes in women with HIV/HBV co-infection are comparable to those with HIV or HBV mono-infection. Recent advances in our understanding of the safety profile and efficacy of tenofovir disoproxil/alafenamide and dolutegravir has resulted in these being recommended as first line antiretrovirals, alongside Lamivudine, for HIV/HBV co-infection in pregnancy in United Kingdom, European and the United States guidelines. Appropriate antiretroviral therapy in pregnancy, along with prompt treatment of the neonate, combine to ensure very low rates of perinatal transmission of both HIV and HBV.