Rotavirus-Associated Adverse Pregnancy Outcomes among Women Without HIV Compared to Women Living with HIV

Background : Although rotavirus infection in pregnancy is generally considered self-limiting, maternal dehydration and systemic inflammatory responses may adversely affect pregnancy outcomes. However, the potential modifying effect of maternal HIV status remains poorly understood. This study examined the prevalence of rotavirus infection and its relationship to adverse pregnancy outcomes among women living with and without HIV. Methods : We conducted a cross-sectional study of 100 pregnant women (50 women with HIV (WWH) and 50 women without HIV(WWoH) attending a public tertiary hospital in Lagos, Nigeria. Stool samples were tested for rotavirus by PCR. HIV status was confirmed using the Nigerian HIV testing algorithm and used to categorize associations with pregnancy outcomes, including low birthweight (LBW), preterm birth, and stillbirth. Results : Overall rotavirus prevalence was 5%, with a higher prevalence in WWoH (8%) compared to WWH (2%). Of the five rotavirus-positive participants, two had Group B rotavirus, 3 had Group C rotavirus, and one was positive for both Group B and Group C. Similarly, the distribution of pregnancy outcomes among the rotavirus-positive participants shows that four had normal pregnancy outcomes, and one had adverse pregnancy outcomes. In contrast, adverse outcomes, including low birthweight (n=6) and combined low birthweight with preterm birth (n=8), occurred exclusively among rotavirus-negative women. Further analysis shows that no stillbirths were associated with rotavirus infection. Additionally, among rotavirus-positive participants, four WWH had normal pregnancy outcomes, whereas one WWoH had an adverse outcome, specifically low birth weight. Conclusion: Rotavirus infection was more frequently detected among WWH than among WWoH. The absence of a consistent association between maternal rotavirus infection and low birth weight, preterm birth, or stillbirth suggests that rotavirus infection during pregnancy did not meaningfully contribute to adverse outcomes in this cohort. Therefore, further studies with larger sample sizes are needed to validate these findings.