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Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Côte d'Ivoire.
AIDS 2008; 22(14):1815-20AIDS

Abstract

BACKGROUND

Pregnancy outcomes in women receiving highly active antiretroviral treatment (HAART) in Africa are not well described.

METHODS

HIV-1-infected pregnant women in the ANRS Ditrame Plus and the MTCT-Plus projects were included. Between March 2001 and July 2003, when HAART was not yet available, women eligible for HAART received a short-course antiretroviral regimen, zidovudine (ZDV) or (ZDV + lamivudine) and single dose of nevirapine for preventing mother-to-child transmission (PMTCT group). Between August 2003 and August 2007, eligible women for HAART received it (HAART group). The frequencies of low birth weight (LBW) (<2500 g), stillbirth and infant mortality are reported. Risk factors associated with LBW were investigated using a logistic regression model.

RESULTS

Of the 326 HIV-infected pregnant women, 175 women received short-course antiretroviral (median CD4 cell count 177 cells/microl) and 151 received HAART (median CD4 cell count 182 cells/microl). At 12 months, three paediatric infections (2.3%) occurred in the HAART group vs. 25 (16.1%) in the PMTCT group (P < 0.001). The rate of LBW was 22.3% in the HAART group and 12.4% in the PMTCT group (P = 0.02). In multivariable analysis (n = 309), after adjustment on maternal CD4 cell count, WHO stage, age and maternal BMI, HAART initiated before pregnancy [adjusted odds ratio (OR) 2.88, 95% confidence interval (CI) 1.10-7.51] and during pregnancy (adjusted OR 2.12, 95% CI 1.15-4.65) and maternal BMI at delivery (adjusted OR 2.43, 95% CI 1.20-4.91) were associated with LBW.

CONCLUSION

HAART in pregnant African women with advanced HIV disease substantially reduced mother-to-child transmission, but was associated with LBW.

Authors+Show Affiliations

ANRS 1201/1202 DITRAME PLUS Project, PACCI Collaboration, Abidjan, Côte d'Ivoire, France. ekouevi@aviso.ciNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18753864

Citation

Ekouevi, Didier K., et al. "Antiretroviral Therapy in Pregnant Women With Advanced HIV Disease and Pregnancy Outcomes in Abidjan, Côte D'Ivoire." AIDS (London, England), vol. 22, no. 14, 2008, pp. 1815-20.
Ekouevi DK, Coffie PA, Becquet R, et al. Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Côte d'Ivoire. AIDS. 2008;22(14):1815-20.
Ekouevi, D. K., Coffie, P. A., Becquet, R., Tonwe-Gold, B., Horo, A., Thiebaut, R., ... Abrams, E. J. (2008). Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Côte d'Ivoire. AIDS (London, England), 22(14), pp. 1815-20. doi:10.1097/QAD.0b013e32830b8ab9.
Ekouevi DK, et al. Antiretroviral Therapy in Pregnant Women With Advanced HIV Disease and Pregnancy Outcomes in Abidjan, Côte D'Ivoire. AIDS. 2008 Sep 12;22(14):1815-20. PubMed PMID: 18753864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Côte d'Ivoire. AU - Ekouevi,Didier K, AU - Coffie,Patrick A, AU - Becquet,Renaud, AU - Tonwe-Gold,Besigin, AU - Horo,Appolinaire, AU - Thiebaut,Rodolphe, AU - Leroy,Valériane, AU - Blanche,Stéphane, AU - Dabis,François, AU - Abrams,Elaine J, PY - 2008/8/30/pubmed PY - 2008/10/23/medline PY - 2008/8/30/entrez SP - 1815 EP - 20 JF - AIDS (London, England) JO - AIDS VL - 22 IS - 14 N2 - BACKGROUND: Pregnancy outcomes in women receiving highly active antiretroviral treatment (HAART) in Africa are not well described. METHODS: HIV-1-infected pregnant women in the ANRS Ditrame Plus and the MTCT-Plus projects were included. Between March 2001 and July 2003, when HAART was not yet available, women eligible for HAART received a short-course antiretroviral regimen, zidovudine (ZDV) or (ZDV + lamivudine) and single dose of nevirapine for preventing mother-to-child transmission (PMTCT group). Between August 2003 and August 2007, eligible women for HAART received it (HAART group). The frequencies of low birth weight (LBW) (<2500 g), stillbirth and infant mortality are reported. Risk factors associated with LBW were investigated using a logistic regression model. RESULTS: Of the 326 HIV-infected pregnant women, 175 women received short-course antiretroviral (median CD4 cell count 177 cells/microl) and 151 received HAART (median CD4 cell count 182 cells/microl). At 12 months, three paediatric infections (2.3%) occurred in the HAART group vs. 25 (16.1%) in the PMTCT group (P < 0.001). The rate of LBW was 22.3% in the HAART group and 12.4% in the PMTCT group (P = 0.02). In multivariable analysis (n = 309), after adjustment on maternal CD4 cell count, WHO stage, age and maternal BMI, HAART initiated before pregnancy [adjusted odds ratio (OR) 2.88, 95% confidence interval (CI) 1.10-7.51] and during pregnancy (adjusted OR 2.12, 95% CI 1.15-4.65) and maternal BMI at delivery (adjusted OR 2.43, 95% CI 1.20-4.91) were associated with LBW. CONCLUSION: HAART in pregnant African women with advanced HIV disease substantially reduced mother-to-child transmission, but was associated with LBW. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/18753864/Antiretroviral_therapy_in_pregnant_women_with_advanced_HIV_disease_and_pregnancy_outcomes_in_Abidjan_Côte_d'Ivoire_ L2 - http://Insights.ovid.com/pubmed?pmid=18753864 DB - PRIME DP - Unbound Medicine ER -