Ana Maria Tudor1, Mariana Mărdărescu2, Cristina Petre3, Ruxandra Neagu Drăghicenoiu3, Rodica Ungurianu3, Cătălin Tilişcan4, Dan Oţelea5, Simona Claudia Cambrea6, Doina Eugenia Tănase7, Ana Maria Schweitzer8, Simona Ruţă9. 1. MD, PhD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 2. MD, PhD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania. 3. MD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania. 4. MD, PhD, National Institute for Infectious Diseases "Prof Dr Matei Balş" Carol Davila, University of Medicine and Pharmacy, Bucharest, Romania. 5. MD, PhD, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania. 6. MD, PhD Pediatric Department, Infectious Diseases Hospital Constanţa, Faculty of Medicine, Ovidius University of Constanţa, Romania. 7. MD, Pediatric Department Infectious Diseases Hospital Constanţa, Romania. 8. Psychologist, Executive Director Baylor Black Sea Foundation, Constanţa, Romania. 9. MD, PhD, Ştefan S. Nicolau Institute of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Abstract
BACKGROUND: The Romanian HIV epidemic is characterized by a high prevalence among children born in the late '80s, perinatally infected. The impact of long-term treatment on their offspring is unknown. We evaluated the influence of prenatal care on the rate of premature birth among the HIV-exposed children of heavily treated HIV-infected mothers in two Romanian centers. METHODS: We retrospectively analyzed data on all patients born by HIV-infected mothers between 2006 and 2012 followed up in two main regional centers. We compared the rate of premature birth and the differences between the sites regarding children and maternal demographic characteristics and antiretroviral exposure in pregnant women. RESULTS: A total of 358 children born to 315 women were enrolled between 2006-2012, 262 children from the National Institute for Infectious Diseases "Prof. Dr. Matei Balş" Bucharest (NIID) and 96 children from the Clinical Infectious Diseases Hospital Constanţa (IDHC). Gender rate in newborns and mean age in mothers were similar. We recorded statistically significant differences between centers in the rate of HIV vertical transmission (16.8% vs. 6.2%, p=0.002) and prematurity (25.2 vs. 14.6%, p=0.023). The most used antiretroviral combination during pregnancy in IDHC was boosted lopinavir and fixed dose zidovudine-lamivudine (66% of cases), while in NIID a greater diversity of antiretrovirals were used. Women from IDHC were more frequently treated during pregnancy (83.3% vs. 68.6%, p=0.004). HCV coinfection and illegal drug use were associated with prematurity in the NIID cohort (p=0.037, p=0.024). CONCLUSION: We found a higher rate of premature birth and HIV infection in NIID. In IDHC we found a higher rate of low birth weight in children and a higher rate of heavily treated women. Prematurity was associated with hepatitis C infection and illegal drug use in the NIID cohort.
BACKGROUND: The Romanian HIV epidemic is characterized by a high prevalence among children born in the late '80s, perinatally infected. The impact of long-term treatment on their offspring is unknown. We evaluated the influence of prenatal care on the rate of premature birth among the HIV-exposed children of heavily treated HIV-infected mothers in two Romanian centers. METHODS: We retrospectively analyzed data on all patients born by HIV-infected mothers between 2006 and 2012 followed up in two main regional centers. We compared the rate of premature birth and the differences between the sites regarding children and maternal demographic characteristics and antiretroviral exposure in pregnant women. RESULTS: A total of 358 children born to 315 women were enrolled between 2006-2012, 262 children from the National Institute for Infectious Diseases "Prof. Dr. Matei Balş" Bucharest (NIID) and 96 children from the Clinical Infectious Diseases Hospital Constanţa (IDHC). Gender rate in newborns and mean age in mothers were similar. We recorded statistically significant differences between centers in the rate of HIV vertical transmission (16.8% vs. 6.2%, p=0.002) and prematurity (25.2 vs. 14.6%, p=0.023). The most used antiretroviral combination during pregnancy in IDHC was boosted lopinavir and fixed dose zidovudine-lamivudine (66% of cases), while in NIID a greater diversity of antiretrovirals were used. Women from IDHC were more frequently treated during pregnancy (83.3% vs. 68.6%, p=0.004). HCV coinfection and illegal drug use were associated with prematurity in the NIID cohort (p=0.037, p=0.024). CONCLUSION: We found a higher rate of premature birth and HIV infection in NIID. In IDHC we found a higher rate of low birth weight in children and a higher rate of heavily treated women. Prematurity was associated with hepatitis C infection and illegal drug use in the NIID cohort.
Entities:
Keywords:
HIV exposure; antiretroviral drugs; prematurity
Authors: Richard S B Wanless; Sorin Rugină; Simona Maria Ruţă; Irina-Magdalena Dumitru; Roxana Carmen Cernat; Heidi L Schwarzwald; Nancy R Calles; Gordon E Schutze; Ana-Maria Schweitzer; Heather R Draper; Mark W Kline Journal: Germs Date: 2013-09-01
Authors: Jennifer N Lind; Emily E Petersen; Philip A Lederer; Ghasi S Phillips-Bell; Cria G Perrine; Ruowei Li; Mark Hudak; Jane A Correia; Andreea A Creanga; William M Sappenfield; John Curran; Carina Blackmore; Sharon M Watkins; Suzanne Anjohrin Journal: MMWR Morb Mortal Wkly Rep Date: 2015-03-06 Impact factor: 17.586