Use of Zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009.


Tariq, S; Townsend, CL; Cortina-Borja, M; Duong, T; Elford, J; Thorne, C; Tookey, PA; on behalf of the European Collaborative Study (ECS) and the Nati, ; (2011) Use of Zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009. Journal of acquired immune deficiency syndromes (1999). ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0b013e31821d34d0

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Abstract

BACKGROUND:: Increasing numbers of women in resource-rich settings are prescribed zidovudine (ZDV)-sparing HAART in pregnancy. We compare ZDV-sparing with ZDV-containing HAART in relation to maternal viral load at delivery, mother-to-child transmission of HIV (MTCT), and congenital abnormality. METHODS:: This is an analysis of data from the National Study of HIV in Pregnancy and Childhood and the European Collaborative Study. Data on 7573 singleton births to diagnosed HIV-infected women between January 2000 and June 2009 were analyzed. Logistic regression models were fitted to estimate adjusted odds ratios (AOR). RESULTS:: Overall 15.8% (1199/7573) of women received ZDV-sparing HAART, with increasing use between 2000 and 2009 (p<0.001). Nearly a fifth (18.4%) of women receiving ZDV-sparing HAART in pregnancy had a detectable viral load at delivery compared with 28.6% of women on ZDV-containing HAART (AOR=0.90; 95% confidence interval (CI) 0.72, 1.14, p=0.4). MTCT rates were 0.8% and 0.9% in the ZDV-sparing and ZDV-containing groups respectively (AOR 1.81; 95% CI 0.77, 4.26, p=0.2). The congenital abnormality rate was the same in both groups (2.7%, AOR 0.98; 95% CI 0.66, 1.45, p=0.9), with no significant difference between the groups in a sub-analysis of pregnancies with first trimester HAART exposure (AOR 0.79; 95% CI 0.48, 1.30, p=0.4). CONCLUSIONS:: We found no difference in risk of detectable viral load at delivery, MTCT or congenital abnormality when comparing ZDV-sparing with ZDV-containing HAART. With increasing use of ZDV-sparing HAART, continued monitoring of pregnancy outcomes and longer-term consequences of in utero exposure to these drugs is required.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 21499113
Web of Science ID: 292033500017
URI: http://researchonline.lshtm.ac.uk/id/eprint/797

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