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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Côte d'Ivoire
AIDS, Volume 22, No. 14, Year 2008
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Description
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/μl) and 151 received HAART (median CD4 cell count 182 cells/μl). 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. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Ékouévi, Didier Koumavi
Cote D'ivoire, Abidjan
Anrs 1201/1202 Ditrame Plus Project
France, Bordeaux
Université de Bordeaux
Coffié, Patrick Ahuatchi
Cote D'ivoire, Abidjan
Anrs 1201/1202 Ditrame Plus Project
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Becquet, Renaud
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Tonwe-Gold, Besigin
France, Bordeaux
Université de Bordeaux
Cote D'ivoire, Abidjan
Aconda
Horo, Apollinaire
Cote D'ivoire, Abidjan
Anrs 1201/1202 Ditrame Plus Project
Thíébaut, Rodolphe
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Leroy, Valeriane
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Blanche, Stéphane
Cote D'ivoire, Abidjan
Aconda
Dabis, Franćois Ç.Ois
France, Bordeaux
Université de Bordeaux
Abrams, Elaine J.
United States, New York
Columbia University
Statistics
Citations: 142
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e32830b8ab9
e-ISSN:
14735571
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Case-Control Study
Study Locations
Ivory Coast
Participants Gender
Female