Maternal HIV-1 disease progression 18-24 months postdelivery according to antiretroviral prophylaxis regimen (triple-antiretroviral prophylaxis during pregnancy and breastfeeding vs zidovudine/single-dose nevirapine prophylaxis): The Kesho Bora randomized controlled trial.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Kesho Bora Study Group

Abstract

Antiretroviral (ARV) prophylaxis effectively reduces mother-to-child transmission of human immunodeficiency virus type 1 (HIV). However, it is unclear whether stopping ARVs after breastfeeding cessation affects maternal HIV disease progression. We assessed 18-24-month postpartum disease progression risk among women in a randomized trial assessing efficacy and safety of prophylactic maternal ARVs. From 2005 to 2008, HIV-infected pregnant women with CD4(+) counts of 200-500/mm(3) were randomized to receive either triple ARV (zidovudine, lamivudine, and lopinavir/ritonavir during pregnancy and breastfeeding) or AZT/sdNVP (zidovudine until delivery with single-dose nevirapine without postpartum prophylaxis). Maternal disease progression was defined as the combined endpoint of death, World Health Organization clinical stage 4 disease, or CD4(+) counts of <200/mm(3). Among 824 randomized women, 789 had at least 1 study visit after cessation of ARV prophylaxis. Following delivery, progression risk up to 24 months postpartum in the triple ARV arm was significantly lower than in the AZT/sdNVP arm (15.7% vs 28.3%; P = .001), but the risks of progression after cessation of ARV prophylaxis (rather than after delivery) were not different (1...Continue Reading

References

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Citations

Aug 7, 2013·Current HIV/AIDS Reports·Deborah JonesRyan Cook
Sep 22, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Renaud Becquet, François Dabis
Nov 13, 2014·Expert Opinion on Drug Safety·Marilia Santini-Oliveira, Beatriz Grinsztejn
Nov 14, 2012·Gynecologic and Obstetric Investigation·Giuseppe BenagianoMario Merialdi
Oct 5, 2014·The Cochrane Database of Systematic Reviews·Angela B WhiteJennifer S Read
Jun 13, 2013·Current Opinion in HIV and AIDS·Nigel Rollins, Hoosen M Coovadia
Nov 13, 2012·Current Opinion in HIV and AIDS·Raph L HamersTobias F Rinke de Wit
Jun 8, 2013·Current Opinion in HIV and AIDS·Marie-Louise Newell, Madeleine J Bunders
Mar 21, 2019·HIV Clinical Trials·Risa M HoffmanUNKNOWN IMPAACT PROMISE 1077BF/FF team
Jul 1, 2018·AIDS and Behavior·Moleen ZunzaUNKNOWN Mother-Infant Health Study (MIHS) Project Steering Committee

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