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Title

Antiretroviral treatment during pregnancy

Authors
Rudin, Christoph
Brinkhof, M. W.
Gremlich, Erika
Wunder, Dorothea
Drack, Gero
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Published in AIDS. 2008, vol. 22, no. 17, p. 2323-2330
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.
Keywords AdolescentAdultAnti-HIV Agents/ therapeutic useAntiretroviral Therapy, Highly Active/ methodsCD4 Lymphocyte CountDrug Administration ScheduleFemaleGestational AgeHIV Infections/ drug therapy/virologyHiv-1HumansInfectious Disease Transmission, Vertical/ prevention & controlPractice Guidelines as TopicPregnancyPregnancy Complications, Infectious/ drug therapy/psychology/virologyRNA, ViralRisk FactorsViral LoadYoung Adult
Identifiers
PMID: 18981771
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KEISER, Olivia et al. Antiretroviral treatment during pregnancy. In: AIDS, 2008, vol. 22, n° 17, p. 2323-2330. https://archive-ouverte.unige.ch/unige:7375

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Deposited on : 2010-06-21

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