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.authorStoszek, Sonia K.
dc.contributor.authorDuarte, Geraldo
dc.contributor.authorHance, Laura Freimanis
dc.contributor.authorPinto, Jorge
dc.contributor.authorGouvea, Maria I.
dc.contributor.authorCohen, Rachel A.
dc.contributor.authorSantos, Breno
dc.contributor.authorTeles, Elizabete
dc.contributor.authorSucci, Regina [UNIFESP]
dc.contributor.authorAlarcon, Jorge O.
dc.contributor.authorRead, Jennifer S.
dc.contributor.authorNISDI Perinatal LILAC Study Grp
dc.contributor.institutionWESTAT Corp
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de Minas Gerais (UFMG)
dc.contributor.institutionHosp Servidores Estado Saude
dc.contributor.institutionHosp Nossa Senhora da Conceicao
dc.contributor.institutionHosp Femina
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Nacl Mayor San Marcos
dc.contributor.institutionEunice Kennedy Shriver Natl Inst Child Hlth & Hum
dc.contributor.institutionUS Dept HHS
dc.date.accessioned2016-01-24T14:31:56Z
dc.date.available2016-01-24T14:31:56Z
dc.date.issued2013-07-01
dc.description.abstractObjective: 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.description.affiliationWESTAT Corp, Hlth Studies Sect, Rockville, MD 20850 USA
dc.description.affiliationUniv São Paulo, Fac Med Ribeirao Preto, BR-14049 Ribeirao Preto, Brazil
dc.description.affiliationUniv Fed Minas Gerais, Dept Pediat, Div Immunol, Belo Horizonte, MG, Brazil
dc.description.affiliationHosp Servidores Estado Saude, Serv Doencas Infecciosas & Parasitarias, Rio de Janeiro, Brazil
dc.description.affiliationHosp Nossa Senhora da Conceicao, Serv Infectol, Porto Alegre, RS, Brazil
dc.description.affiliationHosp Femina, Serv Infectol, Porto Alegre, RS, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUniv Nacl Mayor San Marcos, Inst Med Trop Daniel Alcides Carrion, Lima 14, Peru
dc.description.affiliationEunice Kennedy Shriver Natl Inst Child Hlth & Hum, Pediat Adolescent & Maternal AIDS Branch, NIH, US Dept HHS, Bethesda, MD USA
dc.description.affiliationUS Dept HHS, Natl Vaccine Program Off, Off Assistant Secretary Hlth, Off Secretary, Washington, DC 20201 USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent37-43
dc.identifierhttp://dx.doi.org/10.1016/j.ijgo.2012.12.021
dc.identifier.citationInternational Journal of Gynecology & Obstetrics. Clare: Elsevier B.V., v. 122, n. 1, p. 37-43, 2013.
dc.identifier.doi10.1016/j.ijgo.2012.12.021
dc.identifier.issn0020-7292
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36486
dc.identifier.wosWOS:000320974400009
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofInternational Journal of Gynecology & Obstetrics
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectAntiretroviralen
dc.subjectHIV-1en
dc.subjectLatin Americaen
dc.subjectMother-to-child transmissionen
dc.subjectProphylaxisen
dc.subjectTreatmenten
dc.titleTrends in the management and outcome of HIV-1-infected women and their infants in the NISDI Perinatal and LILAC cohorts, 2002-2009en
dc.typeinfo:eu-repo/semantics/article
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