Document Detail

Premature Delivery in HIV-Infected Women Starting Protease Inhibitor Therapy During Pregnancy: Role of the Ritonavir Boost?
MedLine Citation:
PMID:  22460969     Owner:  NLM     Status:  Publisher    
Background. The association between combination antiretroviral (cARV) therapy use by human immunodeficiency virus (HIV)-infected women during pregnancy and risk of prematurity is still controversial. We explored this question, focusing on the initiation of ritonavir-boosted protease inhibitors (PIs) during pregnancy, which is now standard care.Methods. Trends in prematurity (<37 gestational weeks) were studied among all singleton pregnancies in the Agence Nationale de Recherche sur le SIDA (ANRS) French Perinatal Cohort from 1990 through 2009 (n = 13 271). In-depth analysis was conducted in a more detailed substudy of the cohort, among women starting PI-based ARV therapy during pregnancy (n = 1253). Multivariable analysis adjusted for immunovirological status and known risk factors for prematurity.Results. Prematurity increased from 9.2% during 1990-1993 (no therapy) and 9.6% during 1994-1996 (mostly zidovudine monotherapy) to 12.4% during 1997-1999 (dual-nucleoside analog therapy) and 14.3% during 2005-2009 (routine cARV therapy; P < .01). Prematurity was associated with cARV therapy, compared with zidovudine monotherapy, with an adjusted odds ratio of 1.69 (95% confidence interval [CI], 1.38-2.07; P < .01) when accounting for maternal age, intravenous drug use, geographic origin, and CD4 cell count. During 2005-2009, the prematurity rate was higher with boosted than with nonboosted PI therapy started during pregnancy (14.4% vs 9.1% [P = .05]; adjusted hazard ratio, 2.03 [95% CI, 1.06-3.89; P = .03] in multivariate analysis). The difference concerned mainly induced preterm delivery for maternal or fetal indications (5.6% vs 1.6%; P = .02),Conclusions. The prematurity rate among HIV-infected pregnant women was twice that in the general population in France; this was not entirely explained by sociodemographic characteristics. Prematurity was independently associated with cARV therapy and, particularly, with the initiation of ritonavir-boosted PI therapy during pregnancy.
Jeanne Sibiude; Josiane Warszawski; Roland Tubiana; Catherine Dollfus; Albert Faye; Christine Rouzioux; Jean-Paul Teglas; Dieudonné Ekoukou; Stéphane Blanche; Laurent Mandelbrot
Related Documents :
3003969 - Venom properties of the rattlesnakes (crotalus) inhabiting the baja california region o...
19297419 - Altered activity of lysophospholipase d, which produces bioactive lysophosphatidic acid...
23040449 - Inflammatory bowel disease and pregnancy: lack of knowledge is associated with negative...
1322619 - Maternal leukocyte metabolism during pregnancy and puerperium, and its relation to feta...
1184309 - Choline acetyltransferase and acetylcholine esterase activities in normal and biologica...
2450549 - Universal predictive criteria for neonatal overt thyrotoxicosis requiring treatment.
2025819 - Cesarean sections in alberta from april 1979 to march 1988.
150559 - Congenital x-linked adrenal hypoplasia.
19101459 - Contraceptive method at first sexual intercourse and subsequent pregnancy risk: finding...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-28
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
CESP INSERM U1018, Le Kremlin-Bicêtre.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Long-term Outcome of Patients Presenting With Acute Infectious Encephalitis of Various Causes in Fra...
Next Document:  Impact of antiretroviral therapy on tuberculosis incidence among HIV-positive patients in high-incom...