@article {1837, title = {Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009.}, journal = {J Acquir Immune Defic Syndr}, volume = {57}, year = {2011}, month = {2011 Aug 1}, pages = {326-33}, abstract = {

BACKGROUND: Increasing numbers of women in resource-rich settings are prescribed zidovudine (ZDV)-sparing highly active antiretroviral therapy (HAART) in pregnancy. We compare ZDV-sparing with ZDV-containing HAART in relation to maternal viral load at delivery, mother-to-child transmission (MTCT) of HIV, and congenital abnormality.

METHODS: This is an analysis of data from the National Study of HIV in Pregnancy and Childhood and the European Collaborative Study. Data on 7573 singleton births to diagnosed HIV-infected women between January 2000 and June 2009 were analyzed. Logistic regression models were fitted to estimate adjusted odds ratios (AORs).

RESULTS: Overall, 15.8\% (1199 of 7573) of women received ZDV-sparing HAART, with increasing use between 2000 and 2009 (P < 0.001). Nearly a fifth (18.4\%) of women receiving ZDV-sparing HAART in pregnancy had a detectable viral load at delivery compared with 28.6\% of women on ZDV-containing HAART [AOR 0.90; 95\% confidence interval (CI): 0.72 to 1.14, P = 0.4]. MTCT rates were 0.8\% and 0.9\% in the ZDV-sparing and ZDV-containing groups, respectively (AOR 1.81; 95\% CI: 0.77 to 4.26, P = 0.2). The congenital abnormality rate was the same in both groups (2.7\%, AOR 0.98; 95\% CI: 0.66 to 1.45, P = 0.9), with no significant difference between the groups in a subanalysis of pregnancies with first trimester HAART exposure (AOR 0.79; 95\% CI: 0.48 to 1.30, P = 0.4).

CONCLUSIONS: We found no difference in risk of detectable viral load at delivery, MTCT, or congenital abnormality when comparing ZDV-sparing with ZDV-containing HAART. With increasing use of ZDV-sparing HAART, continued monitoring of pregnancy outcomes and long-term consequences of in utero exposure to these drugs is required.

}, keywords = {Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Europe, Female, HIV Infections, Humans, Infant, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious, Retrospective Studies, Time Factors, Viral Load, Zidovudine}, issn = {1944-7884}, doi = {10.1097/QAI.0b013e31821d34d0}, author = {Tariq, Shema and Townsend, Claire L and Cortina-Borja, Mario and Duong, Trinh and Elford, Jonathan and Thorne, Claire and Tookey, Pat A} }