Antiretroviral treatment during pregnancy
Antiretroviral treatment during pregnancy
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DOI：
10.1097/qad.0b013e3283189bf1
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发表时间：
2008-11-12
期刊：
影响因子：
3.8
通讯作者：
de Tejada, Begona Martinez
中科院分区：
文献类型：
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作者：
Keiser, Olivia;Gayet-Ageron, Angele;de Tejada, Begona Martinez
目的：HIV阳性患者的病毒学失败在妊娠期间特别值得关注。我们比较了病毒学失败和频率的治疗变化，在怀孕和非怀孕妇女的瑞士HIV队列Study.Methods：使用数据372怀孕324名妇女，我们描述了在怀孕期间的抗逆转录病毒治疗。怀孕时接受HAART治疗的孕妇（n = 131）与228名未怀孕妇女（个体间比较）以及怀孕前后相同时间段（个体内比较）相匹配。在怀孕期间开始HAART的妇女（n = 145）进行了比较，578名非怀孕妇女开始HAART.Findings：中位年龄在概念是31岁，16%（n = 50）是通过注射毒品的使用和中位CD 4细胞计数为489细胞/亩。在大多数妊娠中（n = 220，59%），妇女在受孕前就开始了抗逆转录病毒治疗。在妊娠期间开始抗逆转录病毒治疗（n = 145，39%），主要是在妊娠中期（n = 100，69%）。在妊娠晚期开始的35名妇女中，有三分之二（n = 26）在怀孕期间被诊断出感染艾滋病毒。妊娠妇女的病毒学失败风险倾向于低于非妊娠妇女[校正比值比0.52（95%置信区间0.25-1.09，P = 0.08）]，但个体内比较相似（校正比值比1.04，95%置信区间0.48-2.28）。妇女在怀孕期间开始HAART改变治疗往往比nonpregnant women.Conclusion：尽管在怀孕期间发生的生理变化，HIV感染的孕妇是不是在较高的风险病毒学失败。(C)2008年威科健康|利平科特·威廉姆斯和威尔金斯
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/mu l. 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. (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins