Author | Pilotto, Jose H. | |
Author | Velasque, Luciane S. | |
Author | Friedman, Ruth K. | |
Author | Moreira, Ronaldo I. | |
Author | Veloso, Valdiléa G. | |
Author | Grinsztejn, Beatriz | |
Author | Morgado, Mariza G. | |
Author | Watts, D. Heather | |
Author | Currier, Judith S. | |
Author | Hoffman, Risa M. | |
Access date | 2016-09-20T13:58:04Z | |
Available date | 2016-09-20T13:58:04Z | |
Document date | 2011 | |
Citation | PILOTTO, José H. et al. Maternal Outcomes after Highly Active Antiretroviral Therapy for the Prevention of Mother-to-Child Transmission in HIV-infected Women in Brazil. Antiviral therapy, v. 16, n. 3, p. 349-356, 2011. | pt_BR |
ISSN | 1359-6535 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/15865 | |
Language | eng | pt_BR |
Publisher | International Medical Press | pt_BR |
Rights | open access | |
Subject in Portuguese | HIV | pt_BR |
Subject in Portuguese | Gravidez | pt_BR |
Subject in Portuguese | Transmissão mãe-filho | pt_BR |
Subject in Portuguese | Brasil | pt_BR |
Subject in Portuguese | Saúde materna | pt_BR |
Title | Maternal outcomes after HAART for the prevention of mother-to-child transmission in HIV-infected women in Brazil | pt_BR |
Type | Article | |
DOI | 10.3851/IMP1779 | |
Abstract | Background: Information is lacking on outcomes in HIV-infected Brazilian women with CD4(+) T-cell counts >200 cells/mm(3) who initiate HAART for the prevention of mother-to-child transmission, and discontinue after delivery. Methods: Clinical event rates after postpartum HAART discontinuation were calculated for all WHO stage 2-3 events, as well as for HIV progression warranting HAART re-initiation, defined by a WHO stage 4 event and/or CD4(+) T-cell decrease to ≤200 cells/mm(3). Predictors of the WHO stage 2-3 events and HIV progression outcomes were evaluated with Cox's proportional hazards models. Results: A total of 120 women were followed for a mean of 1.5 years after delivery. Overall, 26 women had 30 events as follows: 20 developed WHO stage 2-3 events, yielding an incidence rate of 13/100 person-years (PY; 95% CI 8-20); 10 developed HIV progression requiring HAART re-initiation (incidence ratio 6/100 PY, 95% CI 3-11). Among progressors, a single woman developed a WHO stage 4 clinical event and the remainder had CD4(+) T-cell decreases. Women who had baseline CD4(+) T-cell counts between 200-500 cells/mm(3) had a hazard ratio for WHO stage 2-3 events of 2.5 compared to women with baseline ≥500 cells/mm(3) (95% CI 1.0-6.3; P=0.05). The only significant predictor of HIV progression was baseline CD4(+) T-cell count (hazard ratio 0.99, 95% CI 0.98-0.99; P=0.02). Conclusions: In this observational study, a baseline CD4(+) T-cell count <500 cells/mm(3) was associated with an increased risk of postpartum WHO stage 2-3 clinical events and HIV disease progression. Randomized studies are needed to further evaluate the effect of postpartum treatment discontinuation on maternal health. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil / Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Departamento de Matemática e Estatística. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | National Institutes of Health. Eunice Kennedy Shriver National Institutes of Child Health and Development. USA. | pt_BR |
Affilliation | University of California. David Geffen School of Medicine. Division of Infectious Diseases. Center for Clinical AIDS Research and Education. Los Angeles, USA. | pt_BR |
Affilliation | University of California. David Geffen School of Medicine. Division of Infectious Diseases. Center for Clinical AIDS Research and Education. Los Angeles, USA. | pt_BR |
Subject | HIV | pt_BR |
Subject | Pregnancy | pt_BR |
Subject | Mother-to-child transmission | pt_BR |
Subject | Brazil | pt_BR |
Subject | Maternal Health | pt_BR |
e-ISSN | 2040-2058 | |