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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Increased risk of preterm delivery among HIV-infected women randomized to protease versus nucleoside reverse transcriptase inhibitor-based HAART during pregnancy
Journal of Infectious Diseases, Volume 204, No. 4, Year 2011
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Description
Background. Protease inhibitor (PI)-based highly active antiretroviral therapy (HAART) use in pregnancy has been associated with preterm deliveries in some observational studies. Methods. HIV-infected, HAART-naive pregnant women with CD4+ counts ≥200 cells/mm3 were randomized between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine (PI group) or abacavir/ zidovudine/lamivudine (NRTI group) in a clinical trial to prevent mother-to-child HIV transmission. Risk factors for preterm delivery (<37 weeks) and differences by randomization arm were evaluated for live infants by logistic regression. Results. Preterm delivery rates were higher among 267 women in the PI group than 263 women in the NRTI group (21.4% vs 11.8%, P 5 .003). PI-based HAART was the most significant risk factor for preterm delivery [odds ratio52.03, 95%confidence interval 1.26-3.27, P5.004]. Mean change in maternal bodymass index (BMI) 1 month after HAART initiation was lower in the PI group (P < .001); however, this was not significantly associated with preterm delivery. Neither infant hospitalizations nor mortality through 6 months of life differed by maternal regimen. Conclusions. PI-based HAART was associated with increased preterm delivery but not increased infant hospitalizations or mortality in a clinical trial setting. The association between PI use and lower increase in BMI in late pregnancy warrants further study. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Powis, Kathleen M.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard T.h. Chan School of Public Health
United States, Boston
Center for Biostatistics in Aids Research
Kitch, Douglas
United States, Boston
Brigham and Women's Hospital
Ogwu, Anthony C.
United States, Boston
Beth Israel Deaconess Medical Center
Hughes, Michael D.
United States, Boston
Center for Biostatistics in Aids Research
Lockman, Shahin
United States, Boston
Harvard T.h. Chan School of Public Health
United States, Boston
Center for Biostatistics in Aids Research
United States, Boston
Brigham and Women's Hospital
Leidner, Jean
United States, Boston
Harvard T.h. Chan School of Public Health
van Widenfelt, Erik
United States, Boston
Center for Biostatistics in Aids Research
Moffat, Claire
United States, Boston
Harvard T.h. Chan School of Public Health
Moyo, Sikhulile M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Makhema, Joseph M.
United States, Boston
Harvard T.h. Chan School of Public Health
Essex, Max E.
United States, Boston
Brigham and Women's Hospital
Shapiro, Roger L.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Statistics
Citations: 214
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1093/infdis/jir307
ISSN:
00221899
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Participants Gender
Female