[This corrects the article on p. e71653 in vol. 8.]. Background. HIV infection is a major contributor to maternal mortality in resource-limited settings. The Drug Resource Enhancement Against AIDS and Malnutrition Programme has been promoting HAART use during pregnancy and postpartum for Prevention-of-mother-to-child-HIV transmission (PMTCT) irrespective of maternal CD4 cell counts since 2002. Methods. Records for all HIV+ pregnancies followed in Mozambique and Malawi from 6/2002 to 6/2010 were reviewed. The cohort was comprised by pregnancies where women were referred for PMTCT and started HAART during prenatal care (n = 8172, group 1) and pregnancies where women were referred on established HAART (n = 1978, group 2). Results. 10,150 pregnancies were followed. Median (IQR) baseline values were age 26 years (IQR:23–30), CD4 count 392 cells/mm3 (IQR:258–563), Viral Load log10 3.9 (IQR:3.2–4.4), BMI 23.4 (IQR:21.5–25.7), Hemoglobin 10.0 (IQR: 9.0–11.0). 101 maternal deaths (0.99%) occurred during pregnancy to 6 weeks postpartum: 87 (1.1%) in group 1 and 14 (0.7%) in group 2. Mortality was 1.3% in women with <than 350 CD4 cells/mm3 and 0.7% in women with greater than 350 CD4s cells/mm3 [OR = 1.9 (CL 1.3–2.9) p = 0.001]. Mortality was higher in patients with shorter antenatal HAART: 22/991 (2.2%) if less than 30 days and 79/9159 (0.9%) if 31 days or greater [OR = 2.6 (CL 1.6–4.2) p<0.001]. By multivariate analysis, shorter antenatal HAART (p<0.001), baseline values for CD4 cell count (p = 0.012), hemoglobin (p = 0.02), and BMI (p<0.001) were associated with mortality. Four years later, survival was 92% for women with shorter antenatal HAART and 98% for women on established therapy prior to pregnancy, p = 0.001. Conclusions. Antiretrovirals for PMTCT purposes have significant impact on maternal mortality as do CD4 counts and nutritional status. In resource-limited settings, PMTCT programs should provide universal HAART to all HIV+ pregnant women given its impact in prevention of maternal death

Liotta, G., Mancinelli, S., Nielsen Saines, K., Gennaro, E., Scarcella, P., Magid, N., et al. (2013). Correction: Reduction of Maternal Mortality with Highly Active Antiretroviral Therapy in a Large Cohort of HIV-Infected Pregnant Women in Malawi and Mozambique. PLOS ONE, 8(8) [10.1371/annotation/9ab4708e-650e-411a-b72f-bb85e0845469].

Correction: Reduction of Maternal Mortality with Highly Active Antiretroviral Therapy in a Large Cohort of HIV-Infected Pregnant Women in Malawi and Mozambique

LIOTTA, GIUSEPPE;SCARCELLA, PAOLA;BUONOMO, ERSILIA;
2013-08-19

Abstract

[This corrects the article on p. e71653 in vol. 8.]. Background. HIV infection is a major contributor to maternal mortality in resource-limited settings. The Drug Resource Enhancement Against AIDS and Malnutrition Programme has been promoting HAART use during pregnancy and postpartum for Prevention-of-mother-to-child-HIV transmission (PMTCT) irrespective of maternal CD4 cell counts since 2002. Methods. Records for all HIV+ pregnancies followed in Mozambique and Malawi from 6/2002 to 6/2010 were reviewed. The cohort was comprised by pregnancies where women were referred for PMTCT and started HAART during prenatal care (n = 8172, group 1) and pregnancies where women were referred on established HAART (n = 1978, group 2). Results. 10,150 pregnancies were followed. Median (IQR) baseline values were age 26 years (IQR:23–30), CD4 count 392 cells/mm3 (IQR:258–563), Viral Load log10 3.9 (IQR:3.2–4.4), BMI 23.4 (IQR:21.5–25.7), Hemoglobin 10.0 (IQR: 9.0–11.0). 101 maternal deaths (0.99%) occurred during pregnancy to 6 weeks postpartum: 87 (1.1%) in group 1 and 14 (0.7%) in group 2. Mortality was 1.3% in women with
19-ago-2013
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/42 - IGIENE GENERALE E APPLICATA
English
Con Impact Factor ISI
maternal mortality; HIV/AIDS; antiviral therapy; Sub-Saharan Africa; PMTCT
Liotta, G., Mancinelli, S., Nielsen Saines, K., Gennaro, E., Scarcella, P., Magid, N., et al. (2013). Correction: Reduction of Maternal Mortality with Highly Active Antiretroviral Therapy in a Large Cohort of HIV-Infected Pregnant Women in Malawi and Mozambique. PLOS ONE, 8(8) [10.1371/annotation/9ab4708e-650e-411a-b72f-bb85e0845469].
Liotta, G; Mancinelli, S; Nielsen Saines, K; Gennaro, E; Scarcella, P; Magid, N; Germano, P; Jere, H; Guidotti, G; Buonomo, E; Ciccacci, F; Palombi, L; Marazzi, M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/79299
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