OBJECTIVES: To evaluate the effect of extended antenatal triple antiretroviral therapy (ART) on infant outcomes. DESIGN: Retrospective cohort study using pooled data from health clinics in Malawi and Mozambique from July 2005 to December 2009. METHODS: Computerized records of 3273 HIV-infected pregnant women accessing Drug Resource Enhancement Against AIDS and Malnutrition centers were reviewed. ART regimens consisted of nevirapine-based HAART as of 14-25 weeks gestation until 6 months postpartum. Infant infection was determined at 1, 6 and 12 months of age by branched DNA. RESULTS: A total of 3071 pregnancies resulted in 3148 live births. Lost to follow-up, infant deaths and HIV-1 infection rates at 1 and 12 months were 1.3 and 11.5, 0.8 and 6.7 and 0.8 and 2.0, respectively. Infant HIV-1-free survival at 12 months was 92.5%. Mother-to-child transmission and/or infant deaths correlated with length of maternal antenatal ART by multivariate analysis at 1, 6 and 12 months: 14% in women with more than 30 days of triple antenatal ART and 6.9% in mothers receiving at least 90 days of antenatal ART, P = 0.001. Fifty percent of 54 episodes of transmission occurred in women with higher CD4 cell counts (>350 cells/μl). Infant mortality was 67/1000, lower than background rates (78-100/1000). Growth failure (weight-for-age Z score <-2) was present in 8% of infants around birth, 6% at 6 months, 23% at 12 months (lower than country-specific rates). CONCLUSION: Extended antenatal ART is protective against adverse infant outcomes up to 12 months of age even in children born to mothers with higher CD4 cell counts. PMID: 20885282
Marazzi, M.C., Liotta, G., Nielsen-Saines, K., Haswell, J., Magid, N.A., Buonomo, E., et al. (2010). Extended antenatal antiretroviral use correlates with improved infant outcomes throughout the first year of life. AIDS, 24(18), 2819-2826.
Tipologia: | Articolo su rivista |
Citazione: | Marazzi, M.C., Liotta, G., Nielsen-Saines, K., Haswell, J., Magid, N.A., Buonomo, E., et al. (2010). Extended antenatal antiretroviral use correlates with improved infant outcomes throughout the first year of life. AIDS, 24(18), 2819-2826. |
IF: | Con Impact Factor ISI |
Lingua: | English |
Settore Scientifico Disciplinare: | Settore MED/42 - Igiene Generale e Applicata |
Revisione (peer review): | Sì, ma tipo non specificato |
Tipo: | Articolo |
Rilevanza: | Rilevanza internazionale |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1097/QAD.0b013e32833ff58c |
Stato di pubblicazione: | Pubblicato |
Data di pubblicazione: | 27-nov-2010 |
Titolo: | Extended antenatal antiretroviral use correlates with improved infant outcomes throughout the first year of life |
Autori: | |
Autori: | Marazzi, MC; Liotta, G; Nielsen-Saines, K; Haswell, J; Magid, NA; Buonomo, E; Scarcella, P; Doro Altan, AM; Mancinelli, S; Palombi, L |
Appare nelle tipologie: | 01 - Articolo su rivista |
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