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Maternal and foetal outcomes among 4118 women with HIV infection treated with lopinavir/ritonavir during pregnancy: analysis of population-based surveillance data from the national study of HIV in pregnancy and childhood in the United Kingdom and Ireland.
- Source :
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BMC Infectious Diseases . 2/4/2016, p1-11. 11p. 1 Diagram, 6 Charts. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>The National Study of HIV in Pregnancy and Childhood (NSHPC) conducts comprehensive population-based surveillance of pregnancies in women with HIV infection in the United Kingdom/Ireland. Use of antepartum antiretroviral therapy (ART) for prevention of mother-to-child transmission (MTCT) and to treat maternal infection, if required, is standard practise in this population; lopinavir/ritonavir (LPV/r) is commonly used. The study objective was to examine the use of LPV/r among pregnant women with HIV infection to describe maternal and foetal outcomes.<bold>Methods: </bold>The NSHPC study collected maternal, perinatal and paediatric data through confidential and voluntary obstetric and paediatric reporting schemes. Pregnancies reported to the NSHPC by June 2013, due to deliver 2003-2012 and with LPV/r exposure were included in this analysis, using pregnancy as the unit of observation.<bold>Results: </bold>Four thousand eight hundred sixty-four LPV/r-exposed pregnancies resulting in 4702 deliveries in 4118 women were identified. Maternal region of birth was primarily sub-Saharan Africa (77 %) or United Kingdom/Ireland (14 %). Median maternal age at conception was 30 years. LPV/r was initiated preconception in 980 (20 %) and postconception in 3884 (80 %) pregnancies; median duration of antepartum LPV/r exposure was 270 and 107 days, respectively. Viral load close to delivery was <50 copies/mL in 73 % and <1000 copies/mL in 94 % of women. 63 % of deliveries were by caesarean section (elective, 6 %; emergency, 38 %). Among singleton live births, 13 % were <37 weeks of gestation (2.5 % <32 weeks) and 15 % had birth weight <2500 g (2.3 % <1500 g). MTCT rates were 1.1 (2003-2007) and 0.5 % (2008-2012). 134 live born children (2.9 %) had ≥1 congenital abnormality.<bold>Conclusions: </bold>The results of this analysis using real-world data from a large number of pregnant women with HIV infection in the United Kingdom and Ireland who received LPV/r-containing ART regimens demonstrate that these regimens have a good safety profile and are effective for viral suppression during pregnancy, with associated low rates of MTCT. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PREGNANCY complications
*HIV-positive persons
*ANTIRETROVIRAL agents
*OBSTETRICS
*HUMAN abnormalities
*BREASTFEEDING
*HIV infection transmission
*HETEROCYCLIC compounds
*ANTI-HIV agents
*HIV infection epidemiology
*RITONAVIR
*COMMUNICABLE disease epidemiology
*COMMUNICABLE diseases
*EVALUATION of medical care
*PREGNANCY
*PUBLIC health surveillance
*RESEARCH funding
*THERAPEUTICS
*VERTICAL transmission (Communicable diseases)
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Database :
- Academic Search Index
- Journal :
- BMC Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 112782656
- Full Text :
- https://doi.org/10.1186/s12879-016-1400-y