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首页> 外文期刊>AIDS >Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes.
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Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes.

机译：在产前广泛使用三联抗逆转录病毒疗法来预防HIV-1的母婴传播与良好的妊娠结局相关。

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OBJECTIVE: To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission. METHODS: A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 2005 to December 2009 was conducted in Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) centers. Patients were offered nevirapine-based triple ART initiated in pregnancy until 6 months postpartum. Main outcome measures were maternal mortality, abortion/stillbirth, prematurity, and low birth weight. RESULTS: Maternal mortality was 1.2% (42/3273): 7.4% in 68 women with no antenatal ART and 0.7% in 1370 with at least 90 days of antenatal ART [P < 0.001; odds ratio (OR) 0.29 (95% confidence interval [CI] 0.14-0.96]. Abortion/stillbirth was 5.2% (169/3273): 26.5% in 68 women with no ART and 5.0% in 1370 women with at least 90 days of antenatal ART [P < 0.001; OR 0.39 (95% CI 0.27-0.57)]. Prematurity was 19.1%: 70% in 10 women with no antenatal ART and 8.5% in 1330 women with at least 90 days of antenatal ART [P < 0.001; OR 0.15 (95% CI 0.14-0.19)]. Low birth weight was 11.5% (57/496) and not associated with ART duration. The protective effect of antenatal ART against mortality, fetal demise, and prematurity was independent of CD4 strata. Multivariate analysis for BMI, CD4 cell count, virus load, days in care, predelivery length of ART, and hemoglobin demonstrated an independent association between predelivery length of ART and CD4 with maternal mortality, abortion/stillbirth, and prematurity. ART toxicities were infrequent (5.2%). CONCLUSION: Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women.
机译：目的：评估接受三联抗逆转录病毒疗法（ART）预防母婴传播的一组HIV感染妇女的妊娠结局。方法：一项回顾性队列研究，回顾了2005年7月至2009年12月在马拉维和莫桑比克接受产前护理的3273名HIV阳性妇女的记录，该研究在抗艾滋病和营养不良药物资源（DREAM）中心进行。为患者提供从妊娠开始直至产后6个月的基于奈韦拉平的三联抗逆转录病毒治疗。主要的预后指标是产妇死亡率，流产/死产，早产和低出生体重。结果：孕产妇死亡率为1.2％（42/3273）：68名无产前抗逆转录病毒治疗的妇女为7.4％，1370年有至少90天的抗逆转录病毒治疗的妇女为0.7％[P <0.001;比值比（OR）0.29（95％置信区间[CI] 0.14-0.96]。流产/死胎为5.2％（169/3273）：68名无抗逆转录病毒的女性为26.5％，而1370名至少90天的女性为5.0％产前ART的比例[P <0.001; OR 0.39（95％CI 0.27-0.57）]。早产为19.1％：10例无产前ART的女性为70％，1330例至少有90天ART的女性为8.5％[P <0.001; OR 0.15（95％CI 0.14-0.19）。低出生体重为11.5％（57/496），且与ART持续时间无关;产前ART对死亡率，胎儿死亡和早产的保护作用与CD4分层。对BMI，CD4细胞计数，病毒载量，护理天数，ART的预产期和血红蛋白的多变量分析表明，ART和CD4的预产期与孕产妇死亡率，流产/死产和早产之间存在独立的关联。结论：罕见的（5.2％）结论：产前三联抗逆转录病毒疗法可减少HIV感染妇女的不良妊娠结局。

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