Comorbidades associadas em gestantes vivendo com HIV: análise de adesão ao tratamento, carga viral e CD4 em um hospital de ensino

Abstract

This study aimed to identify the most prevalent comorbidities among pregnant women living with HIV admitted to a teaching hospital in Mato Grosso do Sul, Brazil, and to analyze their relationship with antiretroviral therapy (ART) adherence, viral load, and CD4 T-cell count. This is a documentary, retrospective, and quantitative study based on secondary data extracted from 52 electronic medical records of pregnant women with confirmed HIV infection, hospitalized for delivery or obstetric complications between July 2024 and May 2025. Results showed that 61.5% of the women presented at least one comorbidity, the most common being syphilis, diabetes mellitus, hypertension, illicit drug use, and smoking/alcohol consumption. The presence of comorbidities was associated with poorer immunological and virological outcomes, including higher rates of irregular ART adherence, lower mean CD4 counts, and increased frequency of detectable viral load. Pregnant women using psychoactive substances presented the worst clinical indicators, whereas those without comorbidities had better adherence and higher viral suppression rates. These findings highlight the need for integral and multidisciplinary care tailored to the clinical and social vulnerabilities of this population, emphasizing the importance of high-risk prenatal follow-up, health education, and support strategies that strengthen treatment adherence.