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. 2011 Aug 1;57(4):326-33.
doi: 10.1097/QAI.0b013e31821d34d0.

Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009

Shema Tariq  1 , Claire L Townsend, Mario Cortina-Borja, Trinh Duong, Jonathan Elford, Claire Thorne, Pat A Tookey; European Collaborative Study; National Study of HIV in Pregnancy Childhood
Collaborators, Affiliations

Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009

Shema Tariq et al. J Acquir Immune Defic Syndr. .

Erratum in

  • J Acquir Immune Defic Syndr. 2011 Aug 15;57(5):e117

Abstract

Background: Increasing numbers of women in resource-rich settings are prescribed zidovudine (ZDV)-sparing highly active antiretroviral therapy (HAART) in pregnancy. We compare ZDV-sparing with ZDV-containing HAART in relation to maternal viral load at delivery, mother-to-child transmission (MTCT) of HIV, and congenital abnormality.

Methods: This is an analysis of data from the National Study of HIV in Pregnancy and Childhood and the European Collaborative Study. Data on 7573 singleton births to diagnosed HIV-infected women between January 2000 and June 2009 were analyzed. Logistic regression models were fitted to estimate adjusted odds ratios (AORs).

Results: Overall, 15.8% (1199 of 7573) of women received ZDV-sparing HAART, with increasing use between 2000 and 2009 (P < 0.001). Nearly a fifth (18.4%) of women receiving ZDV-sparing HAART in pregnancy had a detectable viral load at delivery compared with 28.6% of women on ZDV-containing HAART [AOR 0.90; 95% confidence interval (CI): 0.72 to 1.14, P = 0.4]. MTCT rates were 0.8% and 0.9% in the ZDV-sparing and ZDV-containing groups, respectively (AOR 1.81; 95% CI: 0.77 to 4.26, P = 0.2). The congenital abnormality rate was the same in both groups (2.7%, AOR 0.98; 95% CI: 0.66 to 1.45, P = 0.9), with no significant difference between the groups in a subanalysis of pregnancies with first trimester HAART exposure (AOR 0.79; 95% CI: 0.48 to 1.30, P = 0.4).

Conclusions: We found no difference in risk of detectable viral load at delivery, MTCT, or congenital abnormality when comparing ZDV-sparing with ZDV-containing HAART. With increasing use of ZDV-sparing HAART, continued monitoring of pregnancy outcomes and long-term consequences of in utero exposure to these drugs is required.

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Figures

FIGURE
FIGURE
Use of ZDV-sparing HAART over time.
See this image and copyright information in PMC

References

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    1. Duong T, Ades AE, Gibb DM, et al. Vertical transmission rates for HIV in the British Isles: estimates based on surveillance data. BMJ. 1999;319:1227–1229. - PMC - PubMed
    1. Townsend CL, Cortina-Borja M, Peckham CS, et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS. 2008;22:973–981. - PubMed

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