Document Detail


The efficacy and tolerability of combination antiretroviral therapy in pregnancy: infant and maternal outcome.
MedLine Citation:
PMID:  10772084     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Antiretroviral therapy (ART) and Caesarean section (CS) delivery significantly reduce the risk of vertically transmitted HIV infection. Attention must focus on determining the optimal management strategy for HIV-positive pregnancies. Guidelines must reflect not only the activity and tolerability of combination ART in pregnancy for mother and infant and the potential short and long-term infant toxicity, but also whether surgical delivery can confer an added benefit if combination ART had reduced plasma viraemia to undetectable levels. To aid the development of management strategies for the Republic of Ireland, a retrospective detailed review of all HIV-positive pregnancies since the introduction of combination ART was undertaken. Since 1997 there have been 25 deliveries to 24 women. Combination ART reduced plasma viraemia to undetectable levels in 76% mothers at delivery. The CS rate was 28% and no unanticipated infant toxicity was encountered. To date no infant has proven infected. Three infants have seroreverted and 24 of 26 infants have had at least 2 negative HIV ribonucleic acid (RNA) and polymerase chain reaction (PCR) tests. Two infants are less than one month old. In this study, the CS rate of 28% is below that reported from many centres yet no vertical transmission was found. Given the efficacy of ART in reducing plasma viraemia, the additional benefit of CS for these women is questionable.
Authors:
S M Clarke; F Mulcahy; C M Healy; S Condon; K M Butler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of STD & AIDS     Volume:  11     ISSN:  0956-4624     ISO Abbreviation:  Int J STD AIDS     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-27     Completed Date:  2000-06-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9007917     Medline TA:  Int J STD AIDS     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  220-3     Citation Subset:  IM; X    
Affiliation:
Department of Genito-Urinary Medicine, St James' Hospital, Dublin, Ireland. gum@stjames.ie
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-HIV Agents / adverse effects,  therapeutic use*
Drug Therapy, Combination
Female
HIV Infections / drug therapy*,  immunology,  virology
HIV Protease Inhibitors / adverse effects,  therapeutic use*
HIV-1* / genetics
Humans
Indinavir / adverse effects,  therapeutic use
Infant
Lamivudine / adverse effects,  therapeutic use*
Male
Nelfinavir / adverse effects,  therapeutic use
Nevirapine / adverse effects,  therapeutic use
Pregnancy
Pregnancy Outcome
Reverse Transcriptase Inhibitors / adverse effects,  therapeutic use*
Ritonavir / adverse effects,  therapeutic use
Saquinavir / adverse effects,  therapeutic use
Treatment Outcome
Zidovudine / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/HIV Protease Inhibitors; 0/Reverse Transcriptase Inhibitors; 0/Ritonavir; 127779-20-8/Saquinavir; 129618-40-2/Nevirapine; 134678-17-4/Lamivudine; 150378-17-9/Indinavir; 159989-64-7/Nelfinavir; 30516-87-1/Zidovudine

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


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