Management of Human Immunodeficiency Virus–Infected Pregnant Women at Latin American and Caribbean Sites
| Autor: | Pedro Cahn, Edmundo Cardoso, Laura Freimanis-Hance, Marcelo H. Losso, Jorge Pinto, Jennifer S. Read, Geraldo Duarte, Sonia K. Stoszek, Esau Joao |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
medicine.medical_specialty Anti-HIV Agents Population HIV Infections Cohort Studies Acquired immunodeficiency syndrome (AIDS) Pregnancy medicine Humans Prospective Studies Pregnancy Complications Infectious education education.field_of_study Reverse-transcriptase inhibitor Cesarean Section business.industry Obstetrics Infant Newborn Obstetrics and Gynecology Prenatal Care Viral Load medicine.disease Infectious Disease Transmission Vertical CD4 Lymphocyte Count Surgery Low birth weight Breast Feeding Latin America Treatment Outcome Anti-Retroviral Agents Caribbean Region Reverse Transcriptase Inhibitors Female Viral disease medicine.symptom business Breast feeding Viral load medicine.drug |
| Zdroj: | Obstetrics & Gynecology. 109:1358-1367 |
| ISSN: | 0029-7844 |
| DOI: | 10.1097/01.aog.0000265211.76196.ac |
| Popis: | The objective was to describe the management of a population of human immunodeficiency virus (HIV)-infected pregnant women in Latin America and the Caribbean and to assess factors associated with maternal viral load of 1000 copies/ mL or more and with infant HIV-1 infection. Eligibility criteria were enrollment in the prospective cohort study as of March 2006; delivery of a liveborn singleton infant; and completion of the 6-month postpartum or postnatal visit. Of 955 women enrolled in Argentina the Bahamas Brazil and Mexico 770 mother-infant pairs were eligible. At enrollment most women were relatively healthy (87% asymptomatic 59% with viral load less than 1000 copies/mL 62% with CD4+% of 25% or more). Most (99%) received antiretrovirals during pregnancy (56% prophylaxis 44% treatment) and 38% delivered by cesarean before labor and before ruptured membranes. Only 18% of women had a viral load of 1000 copies/mL or more after delivery (associated in adjusted analyses with receipt of antiretrovirals at conception CD4+% [lower] viral load [higher] and country at enrollment enrollment late in pregnancy and inversely related to antiretroviral regimen [two nucleoside or nucleotide analogue reverse transcriptase inhibitors plus one nonnucleoside reverse transcriptase inhibitor] during pregnancy). None of the infants breastfed and all received antiretroviral prophylaxis. Seven infants became infected (0.91%; 95% confidence interval 0.37-1.86). Low birth weight infants and those whose mothers had a low CD4+% at hospital discharge after delivery and were not receiving antiretrovirals at enrollment were at higher risk of HIV infection. Only a minority of women had a viral load of 1000 copies/mL or more around delivery and mother-to-child transmission of HIV occurred rarely (1%). (authors) |
| Databáze: | OpenAIRE |
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