Use of combination neonatal prophylaxis for the prevention of mother-to-child transmission of HIV infection in European high-risk infants
| Autor: | Chiappini, E, Galli, L, Giaquinto, Carlo, Ene, L, Goetghebuer, T, Judd, A, Lisi, C, Malyuta, R, Noguera Julian, A, Ramos, Jt, Rojo Conejo, P, Rudin, C, Tookey, P, de Martino, M, Thorne, C, European, Pregnancy, Paediatric HIV Cohort Collaboration study group in EuroCoord |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Nevirapine Anti-HIV Agents Immunology Population HIV Infections Chemoprevention Young Adult 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Pregnancy medicine Humans Immunology and Allergy 030212 general & internal medicine Pregnancy Complications Infectious Young adult education 0303 health sciences education.field_of_study 030306 microbiology business.industry Infant Newborn Odds ratio medicine.disease Drug Utilization Infectious Disease Transmission Vertical 3. Good health Europe Treatment Outcome Infectious Diseases Cohort Drug Therapy Combination Female business Viral load medicine.drug |
| Zdroj: | AIDS; Vol 27 |
| ISSN: | 0269-9370 |
| DOI: | 10.1097/QAD.0b013e32835cffb1 |
| Popis: | OBJECTIVES To evaluate use of combination neonatal prophylaxis (CNP) in infants at high risk for mother-to-child transmission (MTCT) of HIV in Europe and investigate whether CNP is more effective in preventing MTCT than single drug neonatal prophylaxis (SNP). DESIGN Individual patient-data meta-analysis across eight observational studies. METHODS Factors associated with CNP receipt and with MTCT were explored by logistic regression using data from nonbreastfed infants, born between 1996 and 2010 and at high risk for MTCT. RESULTS In 5285 mother-infant pairs, 1463 (27.7%) had no antenatal or intrapartum antiretroviral prophylaxis, 915 (17.3%) had only intrapartum prophylaxis and 2907 (55.0%) mothers had detectable delivery viral load despite receiving antenatal antiretroviral therapy. Any neonatal prophylaxis was administered to 4623 (87.5%) infants altogether; 1105 (23.9%) received CNP. Factors significantly associated with the receipt of CNP were later calendar birth year, no elective caesarean section, maternal CD4 cell count less than 200 cells/μl, maternal delivery viral load more than 1000 copies/ml, no antenatal antiretroviral therapy, receipt of intrapartum single-dose nevirapine and cohort. After adjustment, absence of neonatal prophylaxis was associated with higher risk of MTCT compared to neonatal prophylaxis [adjusted odds ratio (aOR) 2.29; 95% confidence interval (95% CI) 1.46-2.59; P |
| Databáze: | OpenAIRE |
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