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Resultados adversos de la maternidad entre las personas con el virus de la inmunodeficiencia humana (VIH) que usan

J Sroda Agudogo¹, Maya Jackson-Gibson, Annliz Macharia

¹Beth Israel Deaconess Medical Center, Harvard Medical School, Brigham and Women's Hospital, and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts; the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; the Botswana Harvard Health Partnership and the Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana; and the Effective Care Research Unit, University of the Witwatersrand, Johannesburg, and Walter Sisulu University, East London, South Africa.

Obstetrics and gynecology

|August 21, 2025

Resumen

Los resultados maternos en Botsuana mostraron diferencias mínimas entre las personas con y sin infección por VIH después de la política de tratar a todos. El riesgo de preeclampsia fue menor, pero el riesgo de ruptura uterina fue mayor en las pacientes con VIH.

Área de la Ciencia:

Obstetricia y ginecología
Enfermedades infecciosas
Salud pública

Sus antecedentes:

Alta prevalencia de la infección por el virus de la inmunodeficiencia humana (VIH) en Botsuana.
Implementación de una política de tratamiento integral para el manejo del VIH.
Necesidad de evaluar los resultados maternos en esta población específica.

Objetivo del estudio:

Evaluar los resultados maternos en una gran cohorte con alta prevalencia de VIH en Botsuana.
Comparar la mortalidad materna y la morbilidad obstétrica entre personas VIH positivas y VIH negativas.
Evaluar los resultados tras la aplicación de una política de tratamiento para todo el VIH.

Principales métodos:

Estudio de cohorte retrospectivo.
Datos recogidos de los registros médicos al alta hospitalaria (noviembre de 2021 - diciembre de 2023).
Evaluación de la mortalidad materna y la morbilidad obstétrica (preeclampsia, eclampsia, hemorragia, infección, enfermedades pulmonares y cardíacas agudas) por estado de VIH.

Principales resultados:

Se incluyeron 11.754 participantes; el 18,7% eran mujeres embarazadas con VIH.
No hay diferencias significativas en la hemorragia, la infección, la eclampsia, las condiciones agudas o la mortalidad entre los grupos VIH-positivos y VIH-negativos.
Se observó un riesgo ligeramente reducido de preeclampsia y un riesgo raro y aumentado de ruptura uterina en el grupo VIH positivo.

Conclusiones:

Pequeña diferencia en los resultados obstétricos maternos adversos entre las personas con y sin VIH en la era de tratar todo.
La terapia antirretroviral, en particular los inhibidores de la cadena de integraza como el dolutegravir, parece ser eficaz en el tratamiento del VIH durante el embarazo.
Excepciones clave: un riesgo reducido de preeclampsia y un mayor riesgo de ruptura uterina en personas con VIH.

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