Document Detail


Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009.
MedLine Citation:
PMID:  21499113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increasing numbers of women in resource-rich settings are prescribed zidovudine (ZDV)-sparing highly active antiretroviral therapy (HAART) in pregnancy. We compare ZDV-sparing with ZDV-containing HAART in relation to maternal viral load at delivery, mother-to-child transmission (MTCT) of HIV, and congenital abnormality.
METHODS: This is an analysis of data from the National Study of HIV in Pregnancy and Childhood and the European Collaborative Study. Data on 7573 singleton births to diagnosed HIV-infected women between January 2000 and June 2009 were analyzed. Logistic regression models were fitted to estimate adjusted odds ratios (AORs).
RESULTS: Overall, 15.8% (1199 of 7573) of women received ZDV-sparing HAART, with increasing use between 2000 and 2009 (P < 0.001). Nearly a fifth (18.4%) of women receiving ZDV-sparing HAART in pregnancy had a detectable viral load at delivery compared with 28.6% of women on ZDV-containing HAART [AOR 0.90; 95% confidence interval (CI): 0.72 to 1.14, P = 0.4]. MTCT rates were 0.8% and 0.9% in the ZDV-sparing and ZDV-containing groups, respectively (AOR 1.81; 95% CI: 0.77 to 4.26, P = 0.2). The congenital abnormality rate was the same in both groups (2.7%, AOR 0.98; 95% CI: 0.66 to 1.45, P = 0.9), with no significant difference between the groups in a subanalysis of pregnancies with first trimester HAART exposure (AOR 0.79; 95% CI: 0.48 to 1.30, P = 0.4).
CONCLUSIONS: We found no difference in risk of detectable viral load at delivery, MTCT, or congenital abnormality when comparing ZDV-sparing with ZDV-containing HAART. With increasing use of ZDV-sparing HAART, continued monitoring of pregnancy outcomes and long-term consequences of in utero exposure to these drugs is required.
Authors:
Shema Tariq; Claire L Townsend; Mario Cortina-Borja; Trinh Duong; Jonathan Elford; Claire Thorne; Pat A Tookey; ;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  57     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-22     Completed Date:  2011-10-24     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  326-33     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active*
CD4 Lymphocyte Count
Europe / epidemiology
Female
HIV Infections / drug therapy*,  epidemiology*
Humans
Infant
Infectious Disease Transmission, Vertical / prevention & control
Pregnancy
Pregnancy Complications, Infectious / drug therapy*,  epidemiology
Retrospective Studies
Time Factors
Viral Load
Zidovudine / administration & dosage*
Grant Support
ID/Acronym/Agency:
081082//Wellcome Trust; G0501895//Medical Research Council; G0701648//Medical Research Council; G0701648//Medical Research Council; G0701648(85538)//Medical Research Council; G9620552//Medical Research Council; //Department of Health; //Wellcome Trust
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 4B9XT59T7S/Zidovudine
Investigator
Investigator/Affiliation:
C Giaquinto / ; O Rampon / ; A Mazza / ; A De Rossi / ; I Grosch Wörner / ; J Mok / ; Ma I de José / ; B Larrú Martínez / ; H J Scherpbier / ; M Kreyenbroek / ; M H Godfried / ; F J B Nellen / ; K Boer / ; L Navér / ; B Anzén / ; K Lidman / ; J Levy / ; P Barlow / ; Y Manigart / ; M Hainaut / ; T Goetghebuer / ; B Brichard / ; J De Camps / ; N Thiry / ; G Deboone / ; H Waterloos / ; A De Maria / ; A Mûr / ; A Payà / ; M A López-Vilchez / ; R Carreras / ; N H Valerius / ; V Rosenfeldt / ; O Coll / ; A Suy / ; J M Perez / ; C Fortuny / ; J Boguña / ; V Savasi / ; A Viganò / ; V Giacomet / ; C Cerini / ; C Raimondi / ; G Zuccotti / ; S Alberico / ; M Rabusin / ; M Bernardon / ; W Buffolano / ; R Tiseo / ; P Martinelli / ; M Sansone / ; G Maruotti / ; A Agangi / ; C Tibaldi / ; S Marini / ; G Masuelli / ; C Benedetto / ; T Niemieç / ; M Marczynska / ; S Dobosz / ; J Popielska / ; A Oldakowska / ; Janet Masters / ; Hiwot Haile-Selassie / ; Clare French / ; Icina Shakes /
Comments/Corrections
Erratum In:
J Acquir Immune Defic Syndr. 2011 Aug 15;57(5):e117

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