1. Use of neonatal antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV is decreasing in Western Europe
- Author
-
England, K., Thorne, C., Giaquinto, C., Rampon, O., D’Elia, R., De Rossi, A., Grosch Wörner, I., Mok, J., de José, I., Laaru ́, A., Bates, I., Salas, A., Ma Peña, J., Gonzalez Garcia, J., Arribas Lo pez, J. R., Garcia Rodriguez, M. C., Asensi Botet, F., Otero, M. C., Pérez Tamarit, D., Scherpbier, H. J., Kreyenbroek, M., Godfried, M. H., Nellen, F. J. B., Boer, K., Bohlin, A. B., Lindgren, S., Anzén, B., Lidman, K., Elfgren, K., Gyllensten, K., Pehrson, P. O., Levy, J., Barlow, P., Manigart, Y., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., DE MARIA, Andrea, Bentivoglio, Giorgio, Ferrero, Simone, Gotta, C., Mur, A., Paya, A., López Vilchez, M. A., Carreras, R., Valerius, N. H., Rosenfeldt, V., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Boguña, J., Canet, Y., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Scaravelli, G., Stegagno, M., De Santis, M., Savasi, V., Fiore, S., Cri velli, M., Ferrazzi, E., Vigano`, A., Giacomet, V., Frasca, D., Zuccotti, G., Ravagni Probizer, F., Maccabruni, A., Bucceri, A., Rancilio, L., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Sansone, M., Maruotti, G., Agangi, A., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Marczynska, T. Niemiec ̧ M., Dobosz, S., Popielska, J., and Oldakowska, A.
- Subjects
Microbiology (medical) ,Cart ,Pediatrics ,medicine.medical_specialty ,antiretroviral therapy ,HIV Infections ,Chemoprevention ,Article ,Zidovudine ,Pregnancy ,Medicine ,Humans ,HIV ,pregnancy ,Maternal Transmission ,business.industry ,Infant, Newborn ,medicine.disease ,Infectious Disease Transmission, Vertical ,Europe ,Infectious Diseases ,Chemoprophylaxis ,Cohort ,Observational study ,Female ,business ,Viral load ,medicine.drug - Abstract
To the Editor: Since the ACTG076 trial results were published in 1994 [1], antiretroviral prophylaxis for the neonate as well as during pregnancy and delivery has been the cornerstone of prevention of mother-to-child transmission (MTCT) of HIV. In the second decade of the combination antiretroviral therapy (cART) era, around 90% of pregnant HIV-infected women in Western Europe receive antenatal cART, for their own health and/or for prevention of MTCT (PMTCT) [2-4]. The rationale for including neonatal prophylaxis in the ACTG076 trial included uncertainty regarding timing of MTCT and the desire to boost the infant’s in utero and intrapartum antiretroviral drug exposure with 6 weeks zidovudine prophylaxis, as a post-exposure prophylaxis (PEP) for newborns not infected with HIV in utero. Observational studies and trials subsequently demonstrated effectiveness of neonatal PEP for infants whose mothers received no antiretroviral drugs [5-7]. No trial data exist comparing the efficacy of different neonatal prophylaxis regimens for infants of women on cART. We investigated trends in neonatal prophylaxis use in the cART era in Western European sites of the European Collaborative Study, a cohort of HIV-infected pregnant women and their children; full methods are described elsewhere [4]. Logistic regression was used to investigate factors associated with receipt of neonatal prophylaxis. Variables considered in the multivariable model were antenatal antiretroviral use, mode of delivery, country and year of delivery, prematurity (
- Published
- 2009