HIV-infected pregnant women and vertical transmission in Europe since 1986: European collaborative study

Thorne, C., Newell, M. and Gray, L. (2001) HIV-infected pregnant women and vertical transmission in Europe since 1986: European collaborative study. AIDS, 15(6), pp. 761-770.

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<p>Objective: To describe changes over a 15-year period in characteristics and management of HIV-infected pregnant women in Europe.</p> <p>Design: Prospective study.</p> <p>Methods: Analysis of prospective data on 2876 pregnant HIV-infected women and their 3076 infants. Factors examined included maternal socio-demographic, immunological and virological characteristics, antiretroviral therapy and pregnancy outcome.</p> <p>Results: Among women enrolled, the proportion with heterosexual acquisition of infection has increased significantly from 59% (201/342) in 1985-1987 to 69% (327/471) after 1997 while the proportion acquiring HIV through injecting drug use has declined. Overall median CD4 cell count was 440 × 106/l and 41% of women had undetectable viral load at delivery. In 1995 28% (72/256) of mother-child pairs received the full 076 regimen to reduce risk of vertical transmission, rising significantly to 89% (116/130) by 1999. Use of triple therapy started in pregnancy has increased significantly from < 1% (1/153) in 1997 to 44% (47/107) in 1999. Exposure to antiretroviral therapy was not associated with prevalence or pattern of congenital abnormalities (P = 0.88) but was associated with reversible anaemia in the infant (P < 0.002). The elective cesarean section rate has increased from 10% in 1992 to 71% in 1999/2000. The vertical transmission rate declined from 15.5% by 1994 to 2.6% after 1998. In multivariate analysis, adjusting for maternal CD4 cell count, risk of vertical transmission was reduced by 66% (95% confidence interval, 37-82%) with the full 076 regimen and by 60% (95% confidence interval, 33-73%) with elective cesarean section delivery.</p> <p>Conclusions: Changes in treatment of adult HIV disease have affected the management of infected pregnant women. Despite therapeutic and surgical interventions, vertical transmission still occurs.</p>

Item Type:Articles
Glasgow Author(s) Enlighten ID:Gray, Dr Linsay
Authors: Thorne, C., Newell, M., and Gray, L.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:AIDS

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