Abstract
Objective To describe temporal management and outcome trends among HIV-1-infected pregnant women and their infants enrolled in the NISDI Perinatal and LILAC cohorts. Methods A prospective cohort of 1548 HIV-1-infected pregnant women and their 1481 singleton live-born infants was analyzed. Participants were enrolled at 24 Latin American and Caribbean sites and followed-up for at least 6 months postpartum. Variables were compared by 2-year enrollment periods from September 27, 2002, to June 30, 2009, using logistic and linear regression modeling. Results Antiretroviral (ARV) use during pregnancy remained high (99.0%). ARVs became increasingly used for treatment (P < 0.001). Regimens containing 2 nucleoside reverse transcriptase inhibitors plus a protease inhibitor became more common in later years (P < 0.001). The proportion of women with viral loads below 1000 copies/mL at hospital discharge after delivery (HD) increased over time (P = 0.0031). Median CD4 lymphocyte counts also rose at HD, from 441 cell/mm3 to 515 cells/mm3 (P < 0.05). Elective cesarean deliveries increased from 30.5% to 42.0% (P = 0.018). Most infants received ARV prophylaxis (99.7%). Few infants were breastfed (0.5%) or became infected with HIV-1 (1.2%). Conclusion The results indicate that national HIV-1 treatment and transmission prevention policies are effective among patients with healthcare access in the region.
Original language | English |
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Pages (from-to) | 37-43 |
Number of pages | 7 |
Journal | International Journal of Gynecology and Obstetrics |
Volume | 122 |
Issue number | 1 |
DOIs | |
State | Published - Jul 2013 |
Externally published | Yes |
Keywords
- America
- Antiretroviral
- HIV-1
- Latin
- Mother-to-child transmission
- Prophylaxis
- Treatment