Antiretroviral prophylaxis to prevent perinatal HIV transmission in St. Petersburg, Russia: too little, too late

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Susan HillisWilliam C Miller

Abstract

We evaluated the influence of type and timing of prophylaxis on perinatal HIV transmission in St. Petersburg, Russia. We linked surveillance data for 1498 HIV-infected mothers delivering from 2004 to 2007 with polymerase chain reaction data for 1159 infants to determine predictors of transmission. The overall perinatal transmission rate was 6.3% [73 of 1159, 95% confidence interval (CI) 4.9% to 7.7%]. Among the 12.8% (n = 149) of mother-infant pairs receiving full course (antenatal, intrapartum, postnatal) dual/triple antiretroviral prophylaxis, the transmission rate was 2.7%. Among the 1010 receiving less complete regimens (full course zidovudine, single-dose nevirapine, or incomplete), transmission ranged from 4.1% to 12.2%. Among the 28.9% (330) of mothers initiating antiretroviral drugs <or=20 weeks gestation, perinatal transmission was 1.8%, compared with 4.0%, 8.6%, and 11.3% for those initiating antiretrovirals at 21-28 weeks, 29-42 weeks, or during labor and delivery, respectively (P for trend <0.0001). Compared with those initiating antepartum prophylaxis <or=20 weeks, those initiating antepartum prophylaxis >or=29 weeks (or not at all) had increased transmission odds (adjusted odds ratio: 4.9, 95% CI: 1.8 to 12.9; odd...Continue Reading

References

May 10, 2001·JAMA : the Journal of the American Medical Association·L MandelbrotUNKNOWN Agence Nationale de Recherches sur le SIDA (ANRS) 075 Study Group
May 1, 2002·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Ellen R CooperUNKNOWN Women and Infants' Transmission Study Group
Jul 4, 2002·JAMA : the Journal of the American Medical Association·Alejandro DorenbaumUNKNOWN International PACTG 316 Team
Mar 3, 2007·International Journal of STD & AIDS·Susan D HillisWilliam C Miller

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Citations

Feb 26, 2015·Environmental Health and Preventive Medicine·Olga Vladimirovna Azovtseva, George Sergeyevich Arkhipov

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