Liver Enzyme Elevation in Pregnant Women Receiving Antiretroviral Therapy in the ANRS-French Perinatal Cohort
| Autor: | Roland Tubiana, Françoise Meier, Albert Faye, Jérôme Le Chenadec, Laurent Mandelbrot, Josiane Warszawski, Stéphane Blanche, Jeanne Sibiude |
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| Přispěvatelé: | Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Département d'obstétrique et de gynécologie [AP-HP Hôpital Louis-Mourier] (DHU Risks in Pregnancy), Université Paris Diderot - Paris 7 (UPD7)-Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Département d'infectiologie [AP-HP Hôpital Louis Mourier, Colombes], Hôpital Louis Mourier - AP-HP [Colombes], Service de pédiatrie générale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Evaluation thérapeutique et pharmacologie périnatale et pédiatrique (EA_7323), Université Paris Descartes - Paris 5 (UPD5), This work was supported by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS). ANRS is an autonomous agency at Inserm. The ANRS functions as promotor and funding and had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Jeanne Sibiude received a grant from ANRS [n°14055] and from AIDS Healthcare Foundation for this work., ANRS-French Perinatal Cohort Study Group, Comets, Emmanuelle, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière] |
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Anti-HIV Agents HIV Infections 030312 virology 03 medical and health sciences Young Adult Pregnancy medicine Humans Pharmacology (medical) Aspartate Aminotransferases Pregnancy Complications Infectious 0303 health sciences [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM] Obstetrics business.industry Hazard ratio Lopinavir Alanine Transaminase biochemical phenomena metabolism and nutrition medicine.disease [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM] 3. Good health Regimen Infectious Diseases Nelfinavir Liver Cohort embryonic structures Coinfection Female France business Cholestasis of pregnancy medicine.drug |
| Zdroj: | Journal of Acquired Immune Deficiency Syndromes Journal of Acquired Immune Deficiency Syndromes, Lippincott, Williams & Wilkins, 2019, Epub ahead of print. ⟨10.1097/QAI.0000000000001963⟩ Journal of Acquired Immune Deficiency Syndromes-JAIDS Journal of Acquired Immune Deficiency Syndromes-JAIDS, 2019, Epub ahead of print. ⟨10.1097/QAI.0000000000001963⟩ |
| ISSN: | 1944-7884 2005-2014 1525-4135 |
| Popis: | International audience; BACKGROUND:High rates of liver enzyme elevation (LEE) in women receiving antiretroviral treatment (ART) during pregnancy have been reported but causes remain unclear. We estimated the prevalence and risk factors of LEE in a national prospective multicenter cohort.METHODS:We studied 5748 pregnant women living with HIV enrolled in the French Perinatal Cohort 2005-2014, treated with ART, with no active hepatitis B or C co-infection. Adjusted hazard ratio (aHR) were estimated using Cox models with ART as time-dependent variable, separately for women on ART at conception and those initiating ART during pregnancy.RESULTS:LEE (grade>1) was observed in 16.7%, grade 3-4 in 2%. Among women with LEE, 6.7% had preeclampsia, 9.8% intrahepatic cholestasis of pregnancy, and 1.4% other identified medical causes. Most LEE (82.2%) were unexplained. In women with unexplained LEE, LEE was the reason for hospitalization in 51 (6%) women, cesarean section in 13 (2%), induction of labour in 3 (0.4%), and change in ART regimen in 49 (6%) women. Unexplained LEE was associated with higher risk of preterm births, p |
| Databáze: | OpenAIRE |
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