Document Detail


HIV-1 viremia during the first 28 weeks of pregnancy is not associated with mother-to-child transmission.
MedLine Citation:
PMID:  17293908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is currently recommended that antiretroviral prophylaxis to prevent mother-to-child transmission (MTCT) of HIV be initiated at 14 weeks of gestation. However, the relevance of early-gestation HIV viral load level for intrauterine MTCT is unknown. The objective of this study was to determine the relationship between prenatal maternal viral load and intrauterine MTCT. Records of HIV-infected pregnant women in two centers in Brazil, from 1999 to 2004 were analyzed. Three pregnancy periods were considered: earlier than 14 weeks, 14 to 27 6/7 weeks, and 28 weeks of gestation or more. Peripartum HIV exposure was also computed. Maximum viral load in each period was the measure of HIV exposure. Four hundred fifty-seven HIV-infected pregnant women were evaluated, but 53 were excluded. The MTCT rate was 0.49% (2/404-95% confidence interval (CI95) = 0.14-1.79%). Newborns were not breast-fed. Median viral load for the earlier-than-14-week period was 9,900 copies/mL (P25-75 1,000-50,775 copies/mL), 8,350 copies/mL (P25-75 707-42,000 copies/mL) for the 14 to 27 6/7-week period, and 435 copies/mL (P25-75 90-7,775 copies/mL) after the 28-week period. The peripartum median viral load was 400 copies/mL (P25-75 80-500 copies/mL). MTCT in mothers with VL > 1,000 copies/mL during the first 14 weeks (0.67%, 2/298) was not different from those with VL =1,000 copies/mL (0.0%, 0/96, P=1). Analogously, in the 14 to 27 6/7-week period, MTCT was similar in groups with VL higher (0.68%, 2/292) or lower (0%, 0/106) than 1,000 copies/mL (P=1). Regarding VL >1,000 copies/mL at 28-weeks-or-later and at peripartum periods, MTCT rates were 1.15% (2/173, P = 0.18) and 2.8% (2/71, P = 0.03), respectively. Intrauterine transmission does not seem to be influenced by HIV viremia during the first 28 weeks of pregnancy.
Authors:
J F Senise; R Palacios; Z N Tanno; L Lunardi; G R Waghabi; M J R Vaz; R S Diaz; A Castelo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases     Volume:  10     ISSN:  1413-8670     ISO Abbreviation:  Braz J Infect Dis     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2007-02-12     Completed Date:  2008-07-31     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9812937     Medline TA:  Braz J Infect Dis     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  259-63     Citation Subset:  IM    
Affiliation:
Multidisciplinary Group for Infectious Diseases in Pregnancy, São Paulo Hospital, Department of Infectious Diseases, Federal University of São Paulo/Medical School of São Paulo, São Paulo, SP. j.senise@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active
Female
HIV Infections / drug therapy,  prevention & control*,  transmission
HIV-1*
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control*
Middle Aged
Pregnancy
Pregnancy Complications, Infectious / drug therapy,  prevention & control*,  virology
Pregnancy Trimester, Second
Retrospective Studies
Viral Load*
Chemical
Reg. No./Substance:
0/Anti-HIV Agents

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