Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes
To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission. A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 200...
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| Veröffentlicht in: | AIDS (London) 2011-08, Vol.25 (13), p.1611-1618 |
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| creator | MARAZZI, Maria C PALOMBI, Leonardo NARCISO, Pasquale LIOTTA, Giuseppe NIELSEN-SAINES, Karin HASWELL, Jere ZIMBA, Ines MAGID, Nurja A BUONOMO, Ersilia SCARCELLA, Paola CEFFA, Susanna PATURZO, Giovanna |
| description | To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission.
A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 2005 to December 2009 was conducted in Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) centers. Patients were offered nevirapine-based triple ART initiated in pregnancy until 6 months postpartum. Main outcome measures were maternal mortality, abortion/stillbirth, prematurity, and low birth weight.
Maternal mortality was 1.2% (42/3273): 7.4% in 68 women with no antenatal ART and 0.7% in 1370 with at least 90 days of antenatal ART [P < 0.001; odds ratio (OR) 0.29 (95% confidence interval [CI] 0.14-0.96]. Abortion/stillbirth was 5.2% (169/3273): 26.5% in 68 women with no ART and 5.0% in 1370 women with at least 90 days of antenatal ART [P < 0.001; OR 0.39 (95% CI 0.27-0.57)]. Prematurity was 19.1%: 70% in 10 women with no antenatal ART and 8.5% in 1330 women with at least 90 days of antenatal ART [P < 0.001; OR 0.15 (95% CI 0.14-0.19)]. Low birth weight was 11.5% (57/496) and not associated with ART duration. The protective effect of antenatal ART against mortality, fetal demise, and prematurity was independent of CD4 strata. Multivariate analysis for BMI, CD4 cell count, virus load, days in care, predelivery length of ART, and hemoglobin demonstrated an independent association between predelivery length of ART and CD4 with maternal mortality, abortion/stillbirth, and prematurity. ART toxicities were infrequent (5.2%).
Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women. |
| doi_str_mv | 10.1097/QAD.0b013e3283493ed0 |
| format | Article |
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A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 2005 to December 2009 was conducted in Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) centers. Patients were offered nevirapine-based triple ART initiated in pregnancy until 6 months postpartum. Main outcome measures were maternal mortality, abortion/stillbirth, prematurity, and low birth weight.
Maternal mortality was 1.2% (42/3273): 7.4% in 68 women with no antenatal ART and 0.7% in 1370 with at least 90 days of antenatal ART [P < 0.001; odds ratio (OR) 0.29 (95% confidence interval [CI] 0.14-0.96]. Abortion/stillbirth was 5.2% (169/3273): 26.5% in 68 women with no ART and 5.0% in 1370 women with at least 90 days of antenatal ART [P < 0.001; OR 0.39 (95% CI 0.27-0.57)]. Prematurity was 19.1%: 70% in 10 women with no antenatal ART and 8.5% in 1330 women with at least 90 days of antenatal ART [P < 0.001; OR 0.15 (95% CI 0.14-0.19)]. Low birth weight was 11.5% (57/496) and not associated with ART duration. The protective effect of antenatal ART against mortality, fetal demise, and prematurity was independent of CD4 strata. Multivariate analysis for BMI, CD4 cell count, virus load, days in care, predelivery length of ART, and hemoglobin demonstrated an independent association between predelivery length of ART and CD4 with maternal mortality, abortion/stillbirth, and prematurity. ART toxicities were infrequent (5.2%).
Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0b013e3283493ed0</identifier><identifier>PMID: 21673553</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Anti-HIV Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiviral agents ; Biological and medical sciences ; Drug Therapy, Combination - methods ; Female ; HIV Infections - drug therapy ; HIV Infections - prevention & control ; HIV Infections - transmission ; HIV-1 ; Human immunodeficiency virus 1 ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infectious Disease Transmission, Vertical - prevention & control ; Infectious diseases ; Malawi ; Maternal Mortality ; Medical sciences ; Mozambique ; Nevirapine - therapeutic use ; Pharmacology. Drug treatments ; Pregnancy ; Pregnancy Complications, Infectious - drug therapy ; Pregnancy Complications, Infectious - prevention & control ; Prenatal Care - methods ; Retrospective Studies ; Stillbirth ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult</subject><ispartof>AIDS (London), 2011-08, Vol.25 (13), p.1611-1618</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-4670013ccaf28427953fb024a9839a600ed8f93a4f8ebc1601ffa7ccb072f7873</citedby><cites>FETCH-LOGICAL-c414t-4670013ccaf28427953fb024a9839a600ed8f93a4f8ebc1601ffa7ccb072f7873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24473644$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21673553$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MARAZZI, Maria C</creatorcontrib><creatorcontrib>PALOMBI, Leonardo</creatorcontrib><creatorcontrib>NARCISO, Pasquale</creatorcontrib><creatorcontrib>LIOTTA, Giuseppe</creatorcontrib><creatorcontrib>NIELSEN-SAINES, Karin</creatorcontrib><creatorcontrib>HASWELL, Jere</creatorcontrib><creatorcontrib>ZIMBA, Ines</creatorcontrib><creatorcontrib>MAGID, Nurja A</creatorcontrib><creatorcontrib>BUONOMO, Ersilia</creatorcontrib><creatorcontrib>SCARCELLA, Paola</creatorcontrib><creatorcontrib>CEFFA, Susanna</creatorcontrib><creatorcontrib>PATURZO, Giovanna</creatorcontrib><title>Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission.
A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 2005 to December 2009 was conducted in Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) centers. Patients were offered nevirapine-based triple ART initiated in pregnancy until 6 months postpartum. Main outcome measures were maternal mortality, abortion/stillbirth, prematurity, and low birth weight.
Maternal mortality was 1.2% (42/3273): 7.4% in 68 women with no antenatal ART and 0.7% in 1370 with at least 90 days of antenatal ART [P < 0.001; odds ratio (OR) 0.29 (95% confidence interval [CI] 0.14-0.96]. Abortion/stillbirth was 5.2% (169/3273): 26.5% in 68 women with no ART and 5.0% in 1370 women with at least 90 days of antenatal ART [P < 0.001; OR 0.39 (95% CI 0.27-0.57)]. Prematurity was 19.1%: 70% in 10 women with no antenatal ART and 8.5% in 1330 women with at least 90 days of antenatal ART [P < 0.001; OR 0.15 (95% CI 0.14-0.19)]. Low birth weight was 11.5% (57/496) and not associated with ART duration. The protective effect of antenatal ART against mortality, fetal demise, and prematurity was independent of CD4 strata. Multivariate analysis for BMI, CD4 cell count, virus load, days in care, predelivery length of ART, and hemoglobin demonstrated an independent association between predelivery length of ART and CD4 with maternal mortality, abortion/stillbirth, and prematurity. ART toxicities were infrequent (5.2%).
Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women.</description><subject>Adult</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>Drug Therapy, Combination - methods</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - transmission</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus 1</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infectious Disease Transmission, Vertical - prevention & control</subject><subject>Infectious diseases</subject><subject>Malawi</subject><subject>Maternal Mortality</subject><subject>Medical sciences</subject><subject>Mozambique</subject><subject>Nevirapine - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - drug therapy</subject><subject>Pregnancy Complications, Infectious - prevention & control</subject><subject>Prenatal Care - methods</subject><subject>Retrospective Studies</subject><subject>Stillbirth</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Young Adult</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFu1DAQhi0EokvhDRDyBXFKGcdObB-rttBKlRAScI0mzpgNSuLFdhb2XXhYvOoCEqex5v_-GWt-xl4KuBBg9duPl9cX0IOQJGsjlZU0wCO2EUrLqmm0eMw2ULe2slLDGXuW0jcAaMCYp-ysFq2WTSM37NfNz0zLQAPHpTww48TXRDx4nuO4m-jYHyPlGPZjLGLeUsTdgfsQ-S7SnoocliM_h6NW5VC57TgNxY9LmseUTvrt3ZdKcBdipAkzJf5jzFvucR8i9mVRmfZ1wcUdeFizCzOl5-yJxynRi1M9Z5_f3Xy6uq3uP7y_u7q8r5wSKleq1VDu4Bz62qha20b6HmqF1kiLLQANxluJyhvqnWhBeI_auR507bXR8py9eZi7i-H7Sil35duOpgkXCmvqjLVCGStNIdUD6WJIKZLvdnGcMR46Ad0xlq7E0v0fS7G9Oi1Y-5mGv6Y_ORTg9QnA5HDy5XRuTP84VVJtlZK_AUzbmoU</recordid><startdate>20110824</startdate><enddate>20110824</enddate><creator>MARAZZI, Maria C</creator><creator>PALOMBI, Leonardo</creator><creator>NARCISO, Pasquale</creator><creator>LIOTTA, Giuseppe</creator><creator>NIELSEN-SAINES, Karin</creator><creator>HASWELL, Jere</creator><creator>ZIMBA, Ines</creator><creator>MAGID, Nurja A</creator><creator>BUONOMO, Ersilia</creator><creator>SCARCELLA, Paola</creator><creator>CEFFA, Susanna</creator><creator>PATURZO, Giovanna</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20110824</creationdate><title>Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes</title><author>MARAZZI, Maria C ; PALOMBI, Leonardo ; NARCISO, Pasquale ; LIOTTA, Giuseppe ; NIELSEN-SAINES, Karin ; HASWELL, Jere ; ZIMBA, Ines ; MAGID, Nurja A ; BUONOMO, Ersilia ; SCARCELLA, Paola ; CEFFA, Susanna ; PATURZO, Giovanna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-4670013ccaf28427953fb024a9839a600ed8f93a4f8ebc1601ffa7ccb072f7873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>Drug Therapy, Combination - methods</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - prevention & control</topic><topic>HIV Infections - transmission</topic><topic>HIV-1</topic><topic>Human immunodeficiency virus 1</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infectious Disease Transmission, Vertical - prevention & control</topic><topic>Infectious diseases</topic><topic>Malawi</topic><topic>Maternal Mortality</topic><topic>Medical sciences</topic><topic>Mozambique</topic><topic>Nevirapine - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - drug therapy</topic><topic>Pregnancy Complications, Infectious - prevention & control</topic><topic>Prenatal Care - methods</topic><topic>Retrospective Studies</topic><topic>Stillbirth</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MARAZZI, Maria C</creatorcontrib><creatorcontrib>PALOMBI, Leonardo</creatorcontrib><creatorcontrib>NARCISO, Pasquale</creatorcontrib><creatorcontrib>LIOTTA, Giuseppe</creatorcontrib><creatorcontrib>NIELSEN-SAINES, Karin</creatorcontrib><creatorcontrib>HASWELL, Jere</creatorcontrib><creatorcontrib>ZIMBA, Ines</creatorcontrib><creatorcontrib>MAGID, Nurja A</creatorcontrib><creatorcontrib>BUONOMO, Ersilia</creatorcontrib><creatorcontrib>SCARCELLA, Paola</creatorcontrib><creatorcontrib>CEFFA, Susanna</creatorcontrib><creatorcontrib>PATURZO, Giovanna</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MARAZZI, Maria C</au><au>PALOMBI, Leonardo</au><au>NARCISO, Pasquale</au><au>LIOTTA, Giuseppe</au><au>NIELSEN-SAINES, Karin</au><au>HASWELL, Jere</au><au>ZIMBA, Ines</au><au>MAGID, Nurja A</au><au>BUONOMO, Ersilia</au><au>SCARCELLA, Paola</au><au>CEFFA, Susanna</au><au>PATURZO, Giovanna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2011-08-24</date><risdate>2011</risdate><volume>25</volume><issue>13</issue><spage>1611</spage><epage>1618</epage><pages>1611-1618</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission.
A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 2005 to December 2009 was conducted in Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) centers. Patients were offered nevirapine-based triple ART initiated in pregnancy until 6 months postpartum. Main outcome measures were maternal mortality, abortion/stillbirth, prematurity, and low birth weight.
Maternal mortality was 1.2% (42/3273): 7.4% in 68 women with no antenatal ART and 0.7% in 1370 with at least 90 days of antenatal ART [P < 0.001; odds ratio (OR) 0.29 (95% confidence interval [CI] 0.14-0.96]. Abortion/stillbirth was 5.2% (169/3273): 26.5% in 68 women with no ART and 5.0% in 1370 women with at least 90 days of antenatal ART [P < 0.001; OR 0.39 (95% CI 0.27-0.57)]. Prematurity was 19.1%: 70% in 10 women with no antenatal ART and 8.5% in 1330 women with at least 90 days of antenatal ART [P < 0.001; OR 0.15 (95% CI 0.14-0.19)]. Low birth weight was 11.5% (57/496) and not associated with ART duration. The protective effect of antenatal ART against mortality, fetal demise, and prematurity was independent of CD4 strata. Multivariate analysis for BMI, CD4 cell count, virus load, days in care, predelivery length of ART, and hemoglobin demonstrated an independent association between predelivery length of ART and CD4 with maternal mortality, abortion/stillbirth, and prematurity. ART toxicities were infrequent (5.2%).
Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>21673553</pmid><doi>10.1097/QAD.0b013e3283493ed0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0269-9370 |
| ispartof | AIDS (London), 2011-08, Vol.25 (13), p.1611-1618 |
| issn | 0269-9370 1473-5571 |
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| subjects | Adult Anti-HIV Agents - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Biological and medical sciences Drug Therapy, Combination - methods Female HIV Infections - drug therapy HIV Infections - prevention & control HIV Infections - transmission HIV-1 Human immunodeficiency virus 1 Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infant, Low Birth Weight Infant, Newborn Infant, Premature Infectious Disease Transmission, Vertical - prevention & control Infectious diseases Malawi Maternal Mortality Medical sciences Mozambique Nevirapine - therapeutic use Pharmacology. Drug treatments Pregnancy Pregnancy Complications, Infectious - drug therapy Pregnancy Complications, Infectious - prevention & control Prenatal Care - methods Retrospective Studies Stillbirth Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Young Adult |
| title | Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes |
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