Document Detail


Injecting drug use in pregnant HIV-infected women in Europe.
MedLine Citation:
PMID:  17426368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: to describe the characteristics of pregnant HIV-infected women with past or current injecting drug use (IDU) and their infants in a large European cohort. DESIGN: prospective study. METHODS: analysis of data on HIV-infected pregnant women enrolling in the European Collaborative Study, 1985 to May 2005. Factors examined included injecting behaviour, HIV-related and socio-demographic characteristics and pregnancy outcomes. RESULTS: of the 5566 women enrolled, 2342 (42%) reported ever using injecting drugs, including 862 current users. Most IDUs were white and nulliparous at enrollment. Current IDUs were younger than ex-IDUs (respective median ages, 26.7 and 28.1 years), less likely to be married or cohabiting (57% (319/559) versus 74% (601/809), p<0.001) and more likely to report an IDU sexual partner (63% (483/762) versus 42% (548/1307) p<0.001). Of the current IDUs, 768 (89%) used illicit drugs throughout their pregnancy, with 567 having an infant with drug withdrawal symptoms. Overall, 42% (399/944) IDUs had a CD4 count of >or=500 cells/mm3, with current IDUs slightly more at risk of severe immunosuppression than ex-IDUs (17% versus 12%, p=0.058). Of the 2515 mother-child pairs, 1716 (68%) received no antenatal antiretroviral prophylaxis, 503 (20%) monotherapy or dual therapy and 296 (12%) HAART. The MTCT rate among women receiving any ART was 4.06% (95% CI 2.62-5.98) and 0.93% (95% CI 0.11-3.34) among those on HAART. In multivariable analysis, elective caesarean section was associated with an 82% reduced MTCT risk versus vaginal delivery (AOR 0.18, p<0.001) and maternal HAART with a 77% reduced risk versus no antenatal ART (AOR 0.23, p<0.001). CONCLUSION: among the HIV-infected pregnant women in this cohort, characteristics of current and ex-IDUs differed considerably. However, MTCT risk did not vary according to IDU, and risk factors for transmission were as described for women with no history of IDU in this cohort and elsewhere.
Authors:
Claire Thorne; Marie-Louise Newell
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Medycyna wieku rozwojowego     Volume:  10     ISSN:  1428-345X     ISO Abbreviation:  Med Wieku Rozwoj     Publication Date:    2006 Oct-Dec
Date Detail:
Created Date:  2007-04-11     Completed Date:  2007-08-16     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100928610     Medline TA:  Med Wieku Rozwoj     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  1005-16     Citation Subset:  IM    
Affiliation:
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK. c.thorne@ich.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Drug Therapy, Combination
Europe / epidemiology
Female
HIV Infections / epidemiology*,  etiology,  immunology,  transmission
Humans
Infectious Disease Transmission, Vertical / statistics & numerical data
Pregnancy
Pregnancy Outcome
Prospective Studies
Substance Abuse, Intravenous / complications,  epidemiology*

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