Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Maternal Antiretroviral Therapy for the Prevention of Mother-To-Child Transmission of HIV in Malawi: Maternal and Infant Outcomes Two Years after Delivery
PLoS ONE, Volume 8, No. 7, Article e68950, Year 2013
Notification
URL copied to clipboard!
Description
Background:Optimized preventive strategies are needed to reach the objective of eliminating pediatric AIDS. This study aimed to define the determinants of residual HIV transmission in the context of maternal antiretroviral therapy (ART) administration to pregnant women, to assess infant safety of this strategy, and to evaluate its impact on maternal disease.Methodology/Principal Findings:A total of 311 HIV-infected pregnant women were enrolled in Malawi in an observational study and received a nevirapine-based regimen from week 25 of gestation until 6 months after delivery (end of breastfeeding period) if their CD4+ count was > 350/mm3 at baseline (n = 147), or indefinitely if they met the criteria for treatment (n. 164). Mother/child pairs were followed until 2 years after delivery. The Kaplan-Meier method was used to estimate HIV transmission, maternal disease progression, and survival at 24 months. The rate of HIV infant infection was 3.2% [95% confidence intervals (CI) 1.0-5.4]. Six of the 8 transmissions occurred among mothers with baseline CD4+ count > 350/mm3. HIV-free survival of children was 85.8% (95% CI 81.4-90.1). Children born to mothers with baseline CD4+ count < 350/mm3 were at increased risk of death (hazard ratio 2.6, 95% CI 1.1-6.1). Among women who had stopped treatment the risk of progression to CD4+ count < 350/mm3 was 20.6% (95% CI 9.2-31.9) by 18 months of drug discontinuation.Conclusions:HIV transmission in this cohort was rare however, it occurred in a significative proportion among women with high CD4+ counts. Strategies to improve treatment adherence should be implemented to further reduce HIV transmission. Mortality in the uninfected exposed children was the major determinant of HIV-free survival and was associated to maternal disease stage. Given the considerable proportion of women reaching the criteria for treatment within 18 months of drug discontinuation, life-long ART administration to HIV-infected women should be considered. © 2013 Giuliano et al.
Authors & Co-Authors
Giuliano, Marina
Italy, Rome
Istituto Superiore Di Sanita
Andreotti, Mauro
Italy, Rome
Istituto Superiore Di Sanita
Liotta, Giuseppe
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Jere, Haswell
Malawi, Blantyre
Dream Program
Sagno, Jean Baptiste
Malawi, Blantyre
Dream Program
Maulidi, Martin
Malawi, Blantyre
Dream Program
Mancinelli, Sandro
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Buonomo, Ersilia
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Scarcella, Paola
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Pirillo, Maria Franca
Italy, Rome
Istituto Superiore Di Sanita
Amici, Roberta
Italy, Rome
Istituto Superiore Di Sanita
Ceffa, Susanna
Italy, Rome
Istituto Superiore Di Sanita
Italy, Rome
Dream Program
Vella, Stefano
Italy, Rome
Istituto Superiore Di Sanita
Palombi, Leonardo
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Statistics
Citations: 57
Authors: 14
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0068950
e-ISSN:
19326203
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Malawi
Participants Gender
Female