TY - JOUR T1 - Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009. JF - J Acquir Immune Defic Syndr Y1 - 2011 A1 - Tariq, Shema A1 - Townsend, Claire L A1 - Cortina-Borja, Mario A1 - Duong, Trinh A1 - Elford, Jonathan A1 - Thorne, Claire A1 - Tookey, Pat A KW - Adult KW - Anti-HIV Agents KW - Antiretroviral Therapy, Highly Active KW - CD4 Lymphocyte Count KW - Europe KW - Female KW - HIV Infections KW - Humans KW - Infant KW - Infectious Disease Transmission, Vertical KW - Pregnancy KW - Pregnancy Complications, Infectious KW - Retrospective Studies KW - Time Factors KW - Viral Load KW - Zidovudine AB -

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.

VL - 57 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21499113?dopt=Abstract ER -