Publikation

Antiretroviral treatment during pregnancy

Wissenschaftlicher Artikel/Review - 12.11.2008

Bereiche
PubMed
DOI
Kontakt

Zitation
Keiser O, Swiss HIV Cohort Study (SHCS), de Tejada B, Hirschel B, Drack G, Wunder D, Gremlich E, Brinkhof M, Rudin C, Gayet-Ageron A, Swiss Mother & Child HIV Cohort Study (MoCHiV). Antiretroviral treatment during pregnancy. AIDS (London, England) 2008; 22:2323-30.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
AIDS (London, England) 2008; 22
Veröffentlichungsdatum
12.11.2008
eISSN (Online)
1473-5571
Seiten
2323-30
Kurzbeschreibung/Zielsetzung

OBJECTIVE: Virologic failure of HIV-positive patients is of special concern during pregnancy. We compared virologic failure and the frequency of treatment changes in pregnant and non-pregnant women of the Swiss HIV Cohort Study. METHODS: Using data on 372 pregnancies in 324 women we describe antiretroviral therapy during pregnancy. Pregnant women on HAART at conception (n = 131) were matched to 228 non-pregnant women (interindividual comparison) and to a time period of equal length before and after pregnancy (intraindividual comparison). Women starting HAART during pregnancy (n = 145) were compared with 578 non-pregnant women starting HAART. FINDINGS: The median age at conception was 31 years, 16% (n = 50) were infected through injecting drug use and the median CD4 cell count was 489 cells/microl. In the majority of pregnancies (n = 220, 59%), women had started ART before conception. When ART was started during pregnancy (n = 145, 39%), it was mainly during the second trimester (n = 100, 69%). Two thirds (n = 26) of 35 women starting in the third trimester were diagnosed with HIV during pregnancy. The risk of virologic failure tended to be lower in pregnant than in non-pregnant women [adjusted odds ratio 0.52 (95% confidence interval 0.25-1.09, P = 0.08)], but was similar in the intraindividual comparison (adjusted odds ratio 1.04, 95% confidence interval 0.48-2.28). Women starting HAART during pregnancy changed the treatment less often than non-pregnant women. CONCLUSION: Despite the physiological changes occurring during pregnancy, HIV infected pregnant women are not at higher risk of virologic failure.