HIV-1 viremia during the first 28 weeks of pregnancy is not associated with mother-to-child transmission

HIV-1 viremia during the first 28 weeks of pregnancy is not associated with mother-to-child transmission

Autor Senise, J.f. Autor UNIFESP Google Scholar
Palacios, R. Autor UNIFESP Google Scholar
Tanno, Z.n. Autor UNIFESP Google Scholar
Lunardi, L. Autor UNIFESP Google Scholar
Waghabi, G.r. Autor UNIFESP Google Scholar
Vaz, M.j.r. Autor UNIFESP Google Scholar
Diaz, Ricardo Sobhie Autor UNIFESP Google Scholar
Castelo Filho, Adauto Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Hospital Ipiranga Interdisciplinary Center for Infectious Diseases in Pregnancy Department of Infectious Diseases and Department of Gynecology and Obstetrics
Resumo It is currently recommended that antiretroviral prophylaxis to prevent mother-to-child transmission (MTCT) of HIV be initiated at 14 weeks of gestation. However, the relevance of early-gestation HIV viral load level for intrauterine MTCT is unknown. The objective of this study was to determine the relationship between prenatal maternal viral load and intrauterine MTCT. Records of HIV-infected pregnant women in two centers in Brazil, from 1999 to 2004 were analyzed. Three pregnancy periods were considered: earlier than 14 weeks, 14 to 27 6/7 weeks, and 28 weeks of gestation or more. Peripartum HIV exposure was also computed. Maximum viral load in each period was the measure of HIV exposure. Four hundred fifty-seven HIV-infected pregnant women were evaluated, but 53 were excluded. The MTCT rate was 0.49% (2/404-95% confidence interval (CI95) = 0.14-1.79%). Newborns were not breast-fed. Median viral load for the earlier-than-14-week period was 9,900 copies/mL (P25-75 1,000-50,775 copies/mL), 8,350 copies/mL (P25-75 707-42,000 copies/mL) for the 14 to 27 6/7-week period, and 435 copies/mL (P25-75 90-7,775 copies/mL) after the 28-week period. The peripartum median viral load was 400 copies/mL (P25-75 80-500 copies/mL). MTCT in mothers with VL > 1,000 copies/mL during the first 14 weeks (0.67%, 2/298) was not different from those with VL =1,000 copies/mL (0.0%, 0/96, P=1). Analogously, in the 14 to 27 6/7-week period, MTCT was similar in groups with VL higher (0.68%, 2/292) or lower (0%, 0/106) than 1,000 copies/mL (P=1). Regarding VL >1,000 copies/mL at 28-weeks-or-later and at peripartum periods, MTCT rates were 1.15% (2/173, P = 0.18) and 2.8% (2/71, P = 0.03), respectively. Intrauterine transmission does not seem to be influenced by HIV viremia during the first 28 weeks of pregnancy.
Palavra-chave HIV-1
disease transmission
vertical transmission
antiretroviral therapy
highly active
Brazil
viral load
Idioma Inglês
Financiador Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Data de publicação 2006-08-01
Publicado em Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 10, n. 4, p. 259-263, 2006.
ISSN 1413-8670 (Sherpa/Romeo)
Publicador Brazilian Society of Infectious Diseases
Extensão 259-263
Fonte http://dx.doi.org/10.1590/S1413-86702006000400009
Direito de acesso Acesso aberto Open Access
Tipo Artigo
SciELO S1413-86702006000400009 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/3205

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