Document Detail


Maternal health factors and early pediatric antiretroviral therapy influence the rate of perinatal HIV-1 disease progression in children.
MedLine Citation:
PMID:  12660534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the relationship of maternal health factors and infant antiretroviral treatment to the risk of pediatric disease progression to AIDS or death by 24 months of age. DESIGN: Prospective perinatal HIV-1 transmission and pediatric natural history study. SETTING: Urban medical centers in four cities in the USA. PARTICIPANTS: A total of 2656 pregnant and postpartum HIV-infected women enrolled in the Perinatal AIDS Collaborative Transmission Study (PACTS) and 360 children determined to be HIV-infected. MAIN OUTCOME MEASURES: Pediatric AIDS or death by 24 months of age. RESULTS: Children born to mothers with class C disease, CD4 cell count < 200 x 106/l, or HIV-1 RNA viral load > 100 000 copies/ml progressed more rapidly than children born to mothers with less advanced disease. In a multivariate analysis, there was an increased risk of progression if mothers had Class C disease [relative risk (RR), 1.7; 95% confidence interval (CI), 1.0-2.7] or HIV-1 RNA > 100 000 copies/ml (RR, 2.4; 95% CI, 1.2-4.6) controlling for child antiretroviral therapy and year of birth. Earlier years of birth significantly increased the likelihood of rapid progression (P = 0.01) in this multivariate model. Children who received combination antiretroviral therapies with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor were significantly less likely to progress compared with those receiving no therapy (P = 0.03). CONCLUSIONS: HIV-1-infected infants born to women with advanced HIV-1 disease were at increased risk for rapid disease progression. More recent birth year and early treatment with potent antiretroviral therapy significantly diminished the likelihood of developing AIDS or dying during early childhood.
Authors:
Elaine J Abrams; Jeffrey Wiener; Rosalind Carter; Louise Kuhn; Paul Palumbo; Stephen Nesheim; Francis Lee; Peter Vink; Marc Bulterys;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  AIDS (London, England)     Volume:  17     ISSN:  0269-9370     ISO Abbreviation:  AIDS     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-27     Completed Date:  2003-05-28     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  867-77     Citation Subset:  IM; X    
Affiliation:
Harlem Hospital Center and Columbia University, College of Physicians & Surgeons, New York, New York 10037, USA.
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / prevention & control
Anti-HIV Agents / administration & dosage*
CD4 Lymphocyte Count
Disease Progression
Drug Administration Schedule
Drug Therapy, Combination
Female
HIV Infections / drug therapy*,  immunology,  transmission
HIV Protease Inhibitors / administration & dosage
HIV-1*
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical*
Multivariate Analysis
Pregnancy
Pregnancy Complications, Infectious / immunology,  virology
Prenatal Exposure Delayed Effects
Prognosis
Prospective Studies
Risk Factors
Survival Analysis
Viral Load
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/HIV Protease Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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