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.
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.
Authors: R Nduati; G John; D Mbori-Ngacha; B Richardson; J Overbaugh; A Mwatha; J Ndinya-Achola; J Bwayo; F E Onyango; J Hughes; J Kreiss Journal: JAMA Date: 2000-03-01 Impact factor: 56.272
Authors: Jennifer S Read; Geraldo Duarte; Laura Freimanis Hance; Jorge Pinto; Maria I Gouvea; Rachel A Cohen; Breno Santos; Elizabete Teles; Regina Succi; Jorge Alarcon; Sonia K Stoszek Journal: Int J Epidemiol Date: 2011-02-27 Impact factor: 7.196
Authors: E M Connor; R S Sperling; R Gelber; P Kiselev; G Scott; M J O'Sullivan; R VanDyke; M Bey; W Shearer; R L Jacobson Journal: N Engl J Med Date: 1994-11-03 Impact factor: 91.245
Authors: Kartik K Venkatesh; Leavitt Morrison; Elizabeth G Livingston; Alice Stek; Jennifer S Read; David E Shapiro; Ruth E Tuomala Journal: Obstet Gynecol Date: 2018-05 Impact factor: 7.661
Authors: Marcelo J Wolff; Mark J Giganti; Claudia P Cortes; Pedro Cahn; Beatriz Grinsztejn; Jean W Pape; Denis Padgett; Juan Sierra-Madero; Eduardo Gotuzzo; Stephany N Duda; Catherine C McGowan; Bryan E Shepherd Journal: PLoS One Date: 2017-06-26 Impact factor: 3.240