Antiretroviral treatment during pregnancy.
Details
Serval ID
serval:BIB_33D3E1868134
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Antiretroviral treatment during pregnancy.
Journal
Aids
Working group(s)
Swiss HIV Cohort Study (SHCS), Swiss Mother & Child HIV Cohort Study (MoCHiV)
Contributor(s)
Aebi C., Battegay M., Bernasconi E., Böni J., Brazzola P., Bucher HC., Bürgisser P., Calmy A., Cattacin S., Cavassini , Cheseaux JJ., Drack G., Dubs R., Egger M., Elzi L., Fischer M., Flepp M., Fontana A., Francioli P., Furrer HJ., Fux C., Gayet-Ageron A., Gerber S., Gorgievski M., Grawe C., Günthard H., Gyr T., Hirsch H., Hirschel B., Hösli I., Hüsler M., Kaiser L., Kahlert Ch., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Müller N., Nadal D., Opravil M., Paccaud F., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schüpbach J., Speck R., Taffé P., Telenti A., Trkola A., Vernazza P., Weber R., Wunder D., Wyler CA., Yerly S.
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
22
Number
17
Pages
2323-2330
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
OBJECTIVE: Virologic failure of HIV-positive patients is of special concern during pregnancy. We compared virologic failure and the frequency of treatment changes in pregnant and non-pregnant women of the Swiss HIV Cohort Study.
METHODS: Using data on 372 pregnancies in 324 women we describe antiretroviral therapy during pregnancy. Pregnant women on HAART at conception (n = 131) were matched to 228 non-pregnant women (interindividual comparison) and to a time period of equal length before and after pregnancy (intraindividual comparison). Women starting HAART during pregnancy (n = 145) were compared with 578 non-pregnant women starting HAART.
FINDINGS: The median age at conception was 31 years, 16% (n = 50) were infected through injecting drug use and the median CD4 cell count was 489 cells/microl. In the majority of pregnancies (n = 220, 59%), women had started ART before conception. When ART was started during pregnancy (n = 145, 39%), it was mainly during the second trimester (n = 100, 69%). Two thirds (n = 26) of 35 women starting in the third trimester were diagnosed with HIV during pregnancy. The risk of virologic failure tended to be lower in pregnant than in non-pregnant women [adjusted odds ratio 0.52 (95% confidence interval 0.25-1.09, P = 0.08)], but was similar in the intraindividual comparison (adjusted odds ratio 1.04, 95% confidence interval 0.48-2.28). Women starting HAART during pregnancy changed the treatment less often than non-pregnant women.
CONCLUSION: Despite the physiological changes occurring during pregnancy, HIV infected pregnant women are not at higher risk of virologic failure.
METHODS: Using data on 372 pregnancies in 324 women we describe antiretroviral therapy during pregnancy. Pregnant women on HAART at conception (n = 131) were matched to 228 non-pregnant women (interindividual comparison) and to a time period of equal length before and after pregnancy (intraindividual comparison). Women starting HAART during pregnancy (n = 145) were compared with 578 non-pregnant women starting HAART.
FINDINGS: The median age at conception was 31 years, 16% (n = 50) were infected through injecting drug use and the median CD4 cell count was 489 cells/microl. In the majority of pregnancies (n = 220, 59%), women had started ART before conception. When ART was started during pregnancy (n = 145, 39%), it was mainly during the second trimester (n = 100, 69%). Two thirds (n = 26) of 35 women starting in the third trimester were diagnosed with HIV during pregnancy. The risk of virologic failure tended to be lower in pregnant than in non-pregnant women [adjusted odds ratio 0.52 (95% confidence interval 0.25-1.09, P = 0.08)], but was similar in the intraindividual comparison (adjusted odds ratio 1.04, 95% confidence interval 0.48-2.28). Women starting HAART during pregnancy changed the treatment less often than non-pregnant women.
CONCLUSION: Despite the physiological changes occurring during pregnancy, HIV infected pregnant women are not at higher risk of virologic failure.
Keywords
Adolescent, Adult, Anti-HIV Agents/therapeutic use, Antiretroviral Therapy, Highly Active/methods, CD4 Lymphocyte Count, Drug Administration Schedule, Female, Gestational Age, HIV Infections/drug therapy, HIV Infections/virology, HIV-1, Humans, Infectious Disease Transmission, Vertical/prevention & control, Practice Guidelines as Topic, Pregnancy, Pregnancy Complications, Infectious/drug therapy, Pregnancy Complications, Infectious/psychology, RNA, Viral, Risk Factors, Viral Load, Young Adult
Pubmed
Web of science
Create date
05/03/2009 17:19
Last modification date
20/08/2019 14:20
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