Raji Balasubramanian1, Mary Glenn Fowler, Kenneth Dominguez, Shahin Lockman, Pat A Tookey, Nicole Ngo Giang Huong, Steven Nesheim, Michael D Hughes, Marc Lallemant, Jennifer Tosswill, Nathan Shaffer, Gayle Sherman, Paul Palumbo, David E Shapiro. 1. aDepartment of Biostatistics and Epidemiology, University of Massachusetts-Amherst, Amherst, Massachusetts bDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland cDivision of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia dDivision of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston eDepartment of Immunology and Infectious Diseases, Harvard University, T. H. Chan School of Public Health, Boston, Massachusetts, USA fBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana gUniversity College Institute of Child Health, London, UK hInstitut de recherche pour le développement (IRD) UMI 174-PHPT, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand iDepartment of Biostatistics, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA jVirus Reference Department, National Infection Service, Public Health England, London, UK kDepartment of HIV/AIDS, World Health Organization, Geneva, Switzerland lDepartment of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand and National Institute for Communicable Diseases, Johannesburg, South Africa mSection of Infectious Diseases and International Health, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, New Hampshire nCenter for Biostatistics in AIDS Research, Harvard University T. H. Chan School of Public Health. Boston, Massachusetts, USA.
Abstract
OBJECTIVE: To evaluate the association of type and timing of prophylactic maternal and infant antiretroviral regimen with time to first positive HIV-1 DNA PCR test, in nonbreastfed HIV-infected infants, from populations infected predominantly with HIV-1 non-B subtype virus. DESIGN: Analysis of combined data on nonbreastfed HIV-infected infants from prospective cohorts in Botswana, Thailand, and the United Kingdom (N = 405). METHODS: Parametric models appropriate for interval-censored outcomes estimated the time to first positive PCR according to maternal or infant antiretroviral regimen category and timing of maternal antiretroviral initiation, with adjustment for covariates. RESULTS: Maternal antiretroviral regimens included: no antiretrovirals (n = 138), single-nucleoside analog reverse transcriptase inhibitor (n = 165), single-dose nevirapine with zidovudine (n = 66), and combination prophylaxis with 3 or more antiretrovirals [combination antiretroviral therapy (cART), n = 36]. Type of maternal/infant antiretroviral regimen and timing of maternal antiretroviral initiation were each significantly associated with time to first positive PCR (multivariate P < 0.0001). The probability of a positive test with no antiretrovirals compared with the other regimen/timing groups was significantly lower at 1 day after birth, but did not differ significantly after age 14 days. In a subgroup of 143 infants testing negative at birth, infant cART was significantly associated with longer time to first positive test (multivariate P = 0.04). CONCLUSION: Time to first positive HIV-1 DNA PCR in HIV-1-infected nonbreastfed infants (non-B HIV subtype) may differ according to maternal/infant antiretroviral regimen and may be longer with infant cART, which may have implications for scheduling infant HIV PCR-diagnostic testing and confirming final infant HIV status.
OBJECTIVE: To evaluate the association of type and timing of prophylactic maternal and infant antiretroviral regimen with time to first positive HIV-1 DNA PCR test, in nonbreastfed HIV-infected infants, from populations infected predominantly with HIV-1 non-B subtype virus. DESIGN: Analysis of combined data on nonbreastfed HIV-infected infants from prospective cohorts in Botswana, Thailand, and the United Kingdom (N = 405). METHODS: Parametric models appropriate for interval-censored outcomes estimated the time to first positive PCR according to maternal or infant antiretroviral regimen category and timing of maternal antiretroviral initiation, with adjustment for covariates. RESULTS: Maternal antiretroviral regimens included: no antiretrovirals (n = 138), single-nucleoside analog reverse transcriptase inhibitor (n = 165), single-dose nevirapine with zidovudine (n = 66), and combination prophylaxis with 3 or more antiretrovirals [combination antiretroviral therapy (cART), n = 36]. Type of maternal/infant antiretroviral regimen and timing of maternal antiretroviral initiation were each significantly associated with time to first positive PCR (multivariate P < 0.0001). The probability of a positive test with no antiretrovirals compared with the other regimen/timing groups was significantly lower at 1 day after birth, but did not differ significantly after age 14 days. In a subgroup of 143 infants testing negative at birth, infant cART was significantly associated with longer time to first positive test (multivariate P = 0.04). CONCLUSION: Time to first positive HIV-1 DNA PCR in HIV-1-infected nonbreastfed infants (non-B HIV subtype) may differ according to maternal/infant antiretroviral regimen and may be longer with infant cART, which may have implications for scheduling infant HIV PCR-diagnostic testing and confirming final infant HIV status.
Authors: Gayle G Sherman; Peter A Cooper; Ashraf H Coovadia; Adrian J Puren; Stephanie A Jones; Mantoa Mokhachane; Keith D Bolton Journal: Pediatr Infect Dis J Date: 2005-11 Impact factor: 2.129
Authors: Ibou Thior; Shahin Lockman; Laura M Smeaton; Roger L Shapiro; Carolyn Wester; S Jody Heymann; Peter B Gilbert; Lisa Stevens; Trevor Peter; Soyeon Kim; Erik van Widenfelt; Claire Moffat; Patrick Ndase; Peter Arimi; Poloko Kebaabetswe; Patson Mazonde; Joseph Makhema; Kenneth McIntosh; Vladimir Novitsky; Tun-Hou Lee; Richard Marlink; Stephen Lagakos; Max Essex Journal: JAMA Date: 2006-08-16 Impact factor: 56.272
Authors: M Lallemant; G Jourdain; S Le Coeur; S Kim; S Koetsawang; A M Comeau; W Phoolcharoen; M Essex; K McIntosh; V Vithayasai Journal: N Engl J Med Date: 2000-10-05 Impact factor: 91.245
Authors: N L Young; N Shaffer; T Chaowanachan; T Chotpitayasunondh; N Vanparapar; P A Mock; N Waranawat; K Chokephaibulkit; R Chuachoowong; P Wasinrapee; T D Mastro; R J Simonds Journal: J Acquir Immune Defic Syndr Date: 2000-08-15 Impact factor: 3.731
Authors: Claire L Townsend; Laura Byrne; Mario Cortina-Borja; Claire Thorne; Annemiek de Ruiter; Hermione Lyall; Graham P Taylor; Catherine S Peckham; Pat A Tookey Journal: AIDS Date: 2014-04-24 Impact factor: 4.177
Authors: Claire L Townsend; Mario Cortina-Borja; Catherine S Peckham; Annemiek de Ruiter; Hermione Lyall; Pat A Tookey Journal: AIDS Date: 2008-05-11 Impact factor: 4.177
Authors: Denise J Jamieson; Jill Clark; Athena P Kourtis; Allan W Taylor; Margaret A Lampe; Mary Glenn Fowler; Lynne M Mofenson Journal: Am J Obstet Gynecol Date: 2007-09 Impact factor: 8.661
Authors: A Judd; R A Ferrand; E Jungmann; C Foster; J Masters; B Rice; H Lyall; P A Tookey; K Prime Journal: HIV Med Date: 2009-01-23 Impact factor: 3.180
Authors: Renate Strehlau; Maria Paximadis; Faeezah Patel; Megan Burke; Karl-Gunter Technau; Stephanie Shiau; Elaine J Abrams; Gayle G Sherman; Gillian Hunt; Johanna Ledwaba; Ahmad H Mazanderani; Caroline T Tiemessen; Louise Kuhn Journal: AIDS Date: 2019-09-01 Impact factor: 4.177