To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission. Methods: 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. Results: 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%). Conclusion: Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women

Marazzi, M., Palombi, L., Nielsen Saines, K., Haswell, J., Zimba, I., Magid, N., et al. (2011). Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes. AIDS, 25(13), 1611-1618 [10.1097/QAD.0b013e3283493ed0].

Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes

PALOMBI, LEONARDO;BUONOMO, ERSILIA;SCARCELLA, PAOLA;LIOTTA, GIUSEPPE
2011

Abstract

To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission. Methods: 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. Results: 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%). Conclusion: Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/42 - Igiene Generale e Applicata
English
Con Impact Factor ISI
Adult; Anti-HIV Agents; Drug Therapy, Combination; Female; HIV Infections; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infectious Disease Transmission, Vertical; Malawi; Maternal Mortality; Mozambique; Nevirapine; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Retrospective Studies; Stillbirth; Young Adult; HIV-1
Marazzi, M., Palombi, L., Nielsen Saines, K., Haswell, J., Zimba, I., Magid, N., et al. (2011). Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes. AIDS, 25(13), 1611-1618 [10.1097/QAD.0b013e3283493ed0].
Marazzi, M; Palombi, L; Nielsen Saines, K; Haswell, J; Zimba, I; Magid, N; Buonomo, E; Scarcella, P; Ceffa, S; Paturzo, G; Narciso, P; Liotta, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/135560
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