Editorial: HIV/HBV and/or HCV infections and hepatotoxicity in pregnant and non-pregnant women

Abstract

In recent years, the intersection of viral infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) with hepatotoxicity in women has become an area of increasing concern, especially in populations vulnerable due to pregnancy [1][2][3].Previous studies have primarily focused on the prevalence, transmission risks, and prevention strategies for co-infections of HIV, HBV, and HCV among pregnant women [1][2][3][4][5]. These studies also highlighted the importance of effective antiviral treatments, vaccination coverage, and the role of interventions such as HBV immunoglobulin in reducing mother-to-child transmission of these viruses [2][3][4][5][6][7]. However, there is dearth of studies on the intersection of these viruses in pregnant and non-pregnant women. This Research Topic, focusing on the impact of HIV, HBV, and/or HCV infections on both pregnant and non-pregnant women, explores critical facets of viral transmission, disease management, and complications in these populations. The four studies illustrated in Table 1, shed light on different aspects of managing these viral infections, highlighting the challenges of treatment, prevention, and healthcare delivery.The study by Weng et al.[https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1166530/full] examines the impact of hepatitis B surface antigen (HBsAg) carriage on pregnancy outcomes. This retrospective cohort study, conducted in Shenzhen, China, demonstrates that while HBsAg carriers had a lower risk of some pregnancy complications such as pregnancy-induced hypertension (PIH) and hyperthyroidism, they face a significantly higher risk of intrahepatic cholestasis of pregnancy (ICP) and lower birth weight in their infants. These findings suggest a complex relationship between HBV infection and pregnancy, underlining the need for tailored prenatal care for HBsAg-positive pregnant women. This study buttresses the importance of regular screening and management of HBV during pregnancy to mitigate potential risks to both maternal and fetal health. syphilis, HBV, and malaria. The findings reveal that a significant number of women were not tested for all four infections, with the lowest testing rates observed for HBV. However, the introduction of the four-test panel led to an increase in testing rates and improved service delivery in primary healthcare settings. The study also demonstrated that the panel was cost-effective, reduced healthcare worker workload, and enhanced data management, thereby improving the overall quality of ANC services. These results suggest that integrated testing panels could be an essential tool in low-and middle-income countries striving to reduce maternal and child mortality due to infectious diseases.Lastly, the study by Zhong et al. HBsAg loss rate and 40.43% HBsAg seroconversion rate after 48 weeks of treatment. These results are promising, as they suggest that Peg-IFN could be a viable treatment option for postpartum women with chronic HBV, particularly those experiencing a postpartum flare or those with lower baseline HBsAg levels. Essentially, the study reports no serious adverse events, making Peg-IFN a potentially safe and effective treatment for managing chronic HBV in postpartum women.The findings presented in this research topic underline the complexity of managing viral infections like HIV, HBV, and HCV in pregnant and non-pregnant women. From the impact of hepatitis B on pregnancy complications in China to the challenges of initiating and retaining ART in informal health centers in Cameroon, and the promise of integrated testing panels in Kenya, these studies offer valuable insights into the obstacles faced by healthcare systems in managing viral infections.Furthermore, the exploration of Peg-IFN treatment in postpartum women with chronic HBV provides hope for improved treatment options in this population. Taken together, these studies contribute to a far-reaching understanding of the intricate interplay between viral infections and hepatotoxicity in women. They emphasize the urgent need for more research, improved healthcare strategies, and accessible treatments to reduce the burden of these infections, particularly in lowresource settings. It is clear that a multi-faceted approach, encompassing prevention, early detection, and effective treatment, is essential to improving the health outcomes of women affected by HIV, HBV, and HCV infections.The table summarizes the main results related to HBV on pregnancy outcomes, ART uptake and retention in Cameroon, integrated testing in Kenya, and Peg-IFN treatment for HBV in postpartum women: -Pregnancy Complications: Statistically significant differences in PIH, hypothyroidism, hyperthyroidism, antepartum hemorrhage, ICP.-Birth Weight: Lower birth weight in HBsAg carrier group (aOR = 1.12). -ART Retention: 65.5% retained in care after 3 months.-Factors Affecting ART Retention: Lack of self-efficacy to initiate ART strongly correlated with non-retention (aHR = 5.57).-