Please use this identifier to cite or link to this item: https://repositorio.unifesp.br/handle/11600/36486
Title: Trends in the management and outcome of HIV-1-infected women and their infants in the NISDI Perinatal and LILAC cohorts, 2002-2009
Authors: Stoszek, Sonia K.
Duarte, Geraldo
Hance, Laura Freimanis
Pinto, Jorge
Gouvea, Maria I.
Cohen, Rachel A.
Santos, Breno
Teles, Elizabete
Succi, Regina [UNIFESP]
Alarcon, Jorge O.
Read, Jennifer S.
NISDI Perinatal LILAC Study Grp
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
US Dept HHS
Keywords: Antiretroviral
HIV-1
Latin America
Mother-to-child transmission
Prophylaxis
Treatment
Issue Date: 1-Jul-2013
Publisher: Elsevier B.V.
Citation: International Journal of Gynecology & Obstetrics. Clare: Elsevier B.V., v. 122, n. 1, p. 37-43, 2013.
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.
URI: http://repositorio.unifesp.br/handle/11600/36486
ISSN: 0020-7292
Other Identifiers: http://dx.doi.org/10.1016/j.ijgo.2012.12.021
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