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Elective cesarean delivery plus short-course lamivudine and zidovudine for the prevention of mother-to-child transmission of human immunodeficiency virus type 1.
Am J Obstet Gynecol. 2004 Mar; 190(3):803-8.AJ

Abstract

OBJECTIVE

The purpose of this study was to evaluate the effect of elective cesarean delivery plus a lamivudine-zidovudine prophylaxis regimen on non-breastfeeding mothers with human immunodeficiency virus type 1 and their infants.

STUDY DESIGN

Forty-six antiretroviral-naïve, pregnant women with human immunodeficiency virus type 1 were included. The prophylactic regimen was a lamivudine-zidovudine tablet (150 mg/300 mg) twice daily from week 34 of pregnancy until cesarean delivery at week 38 of gestation, preoperative intravenous zidovudine, and neonatal zidovudine syrup for 4 weeks.

RESULTS

At weeks 34 and 38 of gestation, the median maternal viral loads were, respectively, 3.65 log(10) copies/mL (range, 2.34-4.70 log(10) copies/mL) and 2.51 log(10) copies/mL (range, 2.04-3.66 log(10) copies/mL; P<.001), respectively; the viral reduction was 1.12 log(10) copies/mL (range, -0.16-2.60 log(10) copies/mL), and the CD4(+) cell counts increased from 335 cells/mm(3) (range, 57-974 cells/mm(3)) to 420 cells/mm(3) (range, 84-1,083 cells/mm(3); P=.002). No mother or infant had a serious adverse event. Two infants were infected (4.3%; 95% CI, 0.5%-15.7%); 1 infant had intrapartum infection.

CONCLUSION

Elective cesarean delivery plus short-course lamivudine-zidovudine is safe but does not eliminate mother-to-child transmission of human immunodeficiency virus type 1.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15042018

Citation

Panburana, Panyu, et al. "Elective Cesarean Delivery Plus Short-course Lamivudine and Zidovudine for the Prevention of Mother-to-child Transmission of Human Immunodeficiency Virus Type 1." American Journal of Obstetrics and Gynecology, vol. 190, no. 3, 2004, pp. 803-8.
Panburana P, Sirinavin S, Phuapradit W, et al. Elective cesarean delivery plus short-course lamivudine and zidovudine for the prevention of mother-to-child transmission of human immunodeficiency virus type 1. Am J Obstet Gynecol. 2004;190(3):803-8.
Panburana, P., Sirinavin, S., Phuapradit, W., Vibhagool, A., & Chantratita, W. (2004). Elective cesarean delivery plus short-course lamivudine and zidovudine for the prevention of mother-to-child transmission of human immunodeficiency virus type 1. American Journal of Obstetrics and Gynecology, 190(3), 803-8.
Panburana P, et al. Elective Cesarean Delivery Plus Short-course Lamivudine and Zidovudine for the Prevention of Mother-to-child Transmission of Human Immunodeficiency Virus Type 1. Am J Obstet Gynecol. 2004;190(3):803-8. PubMed PMID: 15042018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elective cesarean delivery plus short-course lamivudine and zidovudine for the prevention of mother-to-child transmission of human immunodeficiency virus type 1. AU - Panburana,Panyu, AU - Sirinavin,Sayomporn, AU - Phuapradit,Winit, AU - Vibhagool,Asda, AU - Chantratita,Wasun, PY - 2004/3/26/pubmed PY - 2004/4/23/medline PY - 2004/3/26/entrez SP - 803 EP - 8 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 190 IS - 3 N2 - OBJECTIVE: The purpose of this study was to evaluate the effect of elective cesarean delivery plus a lamivudine-zidovudine prophylaxis regimen on non-breastfeeding mothers with human immunodeficiency virus type 1 and their infants. STUDY DESIGN: Forty-six antiretroviral-naïve, pregnant women with human immunodeficiency virus type 1 were included. The prophylactic regimen was a lamivudine-zidovudine tablet (150 mg/300 mg) twice daily from week 34 of pregnancy until cesarean delivery at week 38 of gestation, preoperative intravenous zidovudine, and neonatal zidovudine syrup for 4 weeks. RESULTS: At weeks 34 and 38 of gestation, the median maternal viral loads were, respectively, 3.65 log(10) copies/mL (range, 2.34-4.70 log(10) copies/mL) and 2.51 log(10) copies/mL (range, 2.04-3.66 log(10) copies/mL; P<.001), respectively; the viral reduction was 1.12 log(10) copies/mL (range, -0.16-2.60 log(10) copies/mL), and the CD4(+) cell counts increased from 335 cells/mm(3) (range, 57-974 cells/mm(3)) to 420 cells/mm(3) (range, 84-1,083 cells/mm(3); P=.002). No mother or infant had a serious adverse event. Two infants were infected (4.3%; 95% CI, 0.5%-15.7%); 1 infant had intrapartum infection. CONCLUSION: Elective cesarean delivery plus short-course lamivudine-zidovudine is safe but does not eliminate mother-to-child transmission of human immunodeficiency virus type 1. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/15042018/Elective_cesarean_delivery_plus_short_course_lamivudine_and_zidovudine_for_the_prevention_of_mother_to_child_transmission_of_human_immunodeficiency_virus_type_1_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002937803011839 DB - PRIME DP - Unbound Medicine ER -