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

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dc.contributor.author Stoszek, Sonia K.
dc.contributor.author Duarte, Geraldo
dc.contributor.author Hance, Laura Freimanis
dc.contributor.author Pinto, Jorge
dc.contributor.author Gouvea, Maria I.
dc.contributor.author Cohen, Rachel A.
dc.contributor.author Santos, Breno
dc.contributor.author Teles, Elizabete
dc.contributor.author Succi, Regina [UNIFESP]
dc.contributor.author Alarcon, Jorge O.
dc.contributor.author Read, Jennifer S.
dc.contributor.author NISDI Perinatal LILAC Study Grp
dc.date.accessioned 2016-01-24T14:31:56Z
dc.date.available 2016-01-24T14:31:56Z
dc.date.issued 2013-07-01
dc.identifier http://dx.doi.org/10.1016/j.ijgo.2012.12.021
dc.identifier.citation International Journal of Gynecology & Obstetrics. Clare: Elsevier B.V., v. 122, n. 1, p. 37-43, 2013.
dc.identifier.issn 0020-7292
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/36486
dc.description.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. en
dc.format.extent 37-43
dc.language.iso eng
dc.publisher Elsevier B.V.
dc.relation.ispartof International Journal of Gynecology & Obstetrics
dc.rights Acesso restrito
dc.subject Antiretroviral en
dc.subject HIV-1 en
dc.subject Latin America en
dc.subject Mother-to-child transmission en
dc.subject Prophylaxis en
dc.subject Treatment en
dc.title Trends in the management and outcome of HIV-1-infected women and their infants in the NISDI Perinatal and LILAC cohorts, 2002-2009 en
dc.type Artigo
dc.rights.license http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.contributor.institution WESTAT Corp
dc.contributor.institution Universidade de São Paulo (USP)
dc.contributor.institution Universidade Federal de Minas Gerais (UFMG)
dc.contributor.institution Hosp Servidores Estado Saude
dc.contributor.institution Hosp Nossa Senhora da Conceicao
dc.contributor.institution Hosp Femina
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Univ Nacl Mayor San Marcos
dc.contributor.institution Eunice Kennedy Shriver Natl Inst Child Hlth & Hum
dc.contributor.institution US Dept HHS
dc.description.affiliation WESTAT Corp, Hlth Studies Sect, Rockville, MD 20850 USA
dc.description.affiliation Univ São Paulo, Fac Med Ribeirao Preto, BR-14049 Ribeirao Preto, Brazil
dc.description.affiliation Univ Fed Minas Gerais, Dept Pediat, Div Immunol, Belo Horizonte, MG, Brazil
dc.description.affiliation Hosp Servidores Estado Saude, Serv Doencas Infecciosas & Parasitarias, Rio de Janeiro, Brazil
dc.description.affiliation Hosp Nossa Senhora da Conceicao, Serv Infectol, Porto Alegre, RS, Brazil
dc.description.affiliation Hosp Femina, Serv Infectol, Porto Alegre, RS, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliation Univ Nacl Mayor San Marcos, Inst Med Trop Daniel Alcides Carrion, Lima 14, Peru
dc.description.affiliation Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Pediat Adolescent & Maternal AIDS Branch, NIH, US Dept HHS, Bethesda, MD USA
dc.description.affiliation US Dept HHS, Natl Vaccine Program Off, Off Assistant Secretary Hlth, Off Secretary, Washington, DC 20201 USA
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.identifier.doi 10.1016/j.ijgo.2012.12.021
dc.description.source Web of Science
dc.identifier.wos WOS:000320974400009



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