@article {3637, title = {The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection.}, journal = {BMC Infect Dis}, volume = {14}, year = {2014}, month = {2014}, pages = {277}, abstract = {

BACKGROUND: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.

METHODS: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.

RESULTS: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87\%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 - 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection.

CONCLUSIONS: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

}, keywords = {Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Birth Weight, Cesarean Section, Child, Female, HIV Infections, HIV-1, Humans, Infant, Infectious Disease Transmission, Vertical, Italy, Male, Pediatrics, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Outcome, Prospective Studies, Viral Load, Young Adult, Zidovudine}, issn = {1471-2334}, doi = {10.1186/1471-2334-14-277}, author = {Calitri, Carmelina and Gabiano, Clara and Galli, Luisa and Chiappini, Elena and Giaquinto, Carlo and Buffolano, Wilma and Genovese, Orazio and Esposito, Susanna and Bernardi, Stefania and de Martino, Maurizio and Tovo, Pier-Angelo} }