Trends in the management and outcome of HIV-1-infected women and their infants in the NISDI Perinatal and LILAC cohorts, 2002-2009

Trends in the management and outcome of HIV-1-infected women and their infants in the NISDI Perinatal and LILAC cohorts, 2002-2009

Author Stoszek, Sonia K. Google Scholar
Duarte, Geraldo Google Scholar
Hance, Laura Freimanis Google Scholar
Pinto, Jorge Google Scholar
Gouvea, Maria I. Google Scholar
Cohen, Rachel A. Google Scholar
Santos, Breno Google Scholar
Teles, Elizabete Google Scholar
Succi, Regina Autor UNIFESP Google Scholar
Alarcon, Jorge O. Google Scholar
Read, Jennifer S. Google Scholar
NISDI Perinatal LILAC Study Grp Google Scholar
Institution WESTAT Corp
Universidade de São Paulo (USP)
Universidade Federal de Minas Gerais (UFMG)
Hosp Servidores Estado Saude
Hosp Nossa Senhora da Conceicao
Hosp Femina
Universidade Federal de São Paulo (UNIFESP)
Univ Nacl Mayor San Marcos
Eunice Kennedy Shriver Natl Inst Child Hlth & Hum
Abstract Objective: To describe temporal management and outcome trends among HIV-1-infected pregnant women and their infants enrolled in the NISDI Perinatal and LILAC cohorts. Methods: A prospective cohort of 1548 HIV-1-infected pregnant women and their 1481 singleton live-born infants was analyzed. Participants were enrolled at 24 Latin American and Caribbean sites and followed-up for at least 6 months postpartum. Variables were compared by 2-year enrollment periods from September 27, 2002, to June 30, 2009, using logistic and linear regression modeling. Results: Antiretroviral (ARV) use during pregnancy remained high (99.0%). ARVs became increasingly used for treatment (P < 0.001). Regimens containing 2 nucleoside reverse transcriptase inhibitors plus a protease inhibitor became more common in later years (P < 0.001). the proportion of women with viral loads below 1000 copies/mL at hospital discharge after delivery (HD) increased over time (P = 0.0031). Median CD4 lymphocyte counts also rose at HD, from 441 cell/mm(3) to 515 cells/mm(3) (P < 0.05). Elective cesarean deliveries increased from 30.5% to 42.0% (P = 0.018). Most infants received ARV prophylaxis (99.7%). Few infants were breastfed (0.5%) or became infected with HIV-1 (1.2%). Conclusion: the results indicate that national HIV-1 treatment and transmission prevention policies are effective among patients with healthcare access in the region. (c) 2013 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.
Keywords Antiretroviral
Latin America
Mother-to-child transmission
Language English
Date 2013-07-01
Published in International Journal of Gynecology & Obstetrics. Clare: Elsevier B.V., v. 122, n. 1, p. 37-43, 2013.
ISSN 0020-7292 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 37-43
Access rights Closed access
Type Article
Web of Science ID WOS:000320974400009

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