Effect of Antiretroviral Drugs on Maternal Cd4 Lymphocyte Counts, Hiv-1 Rna Levels, and Anthropometric Parameters of Their Neonates

Abstract

PURPOSE: To study the effect of antiretroviral drugs administered during pregnancy on CD 4 lymphocyte counts and HIV-1 RNA levels of pregnant women and on the anthropometric parameters of their neonates. METHODS: A prospective study was conducted on 57 pregnant women and their neonates divided into 3 groups: ZDV Group, HIV-infected mothers taking zidovudine (n = 20); triple therapy (TT) Group, mothers taking zidovudine + lamivudine + nelfinavir (n = 25), and Control Group, normal women (n = 12). CD 4 lymphocyte counts and HIV-1 RNA levels of pregnant women were analyzed during two periods of pregnancy. The perinatal prognosis took into account preterm rates, birth weight, intrauterine growth restriction, perinatal death, and vertical transmission of HIV-1. Data were analyzed statistically using the nonparametric chi-square, Mann-Whitney, Friedman, Kruskal-Wallis, and Wilcoxon matched pairs tests, with the level of significance set at P <.05. RESULTS: The major maternal demographic and anthropometric data were homogeneous for the various groups. HIV-1 viral burden, which was initially elevated, median of 14,370 copies/mL, was significantly reduced in the TT group, reaching 40 copies/mL. With respect to T-CD 4 + lymphocyte counts, there was a significant recovery in Group TT at the end of pregnancy, this value being significantly different from that for the ZDV group (P =.0052). There was no difference between groups regarding gestation length, Apgar scores, or neonatal anthropometric classification. There was no case of vertical HIV-1 transmission. CONCLUSIONS: The results obtained for the present series demonstrate the efficiency and suggest safety of the use of antiretroviral drugs during pregnancy as revealed by anthropometric parameters of the neonate.

Antiretroviral agents and acid-base balance at delivery of the neonate

“…Limited evidence is available regarding ARV safety for uninfected infants exposed to these drugs in utero. Most of the studies that have addressed the intrauterine well-being of these infants have determined a perinatal prognosis based on Apgar scores and fetal and neonatal death (4,5). In addition, umbilical artery blood pH and gas analysis are increasingly recognized as the most reliable indicators of fetal oxygenation and acid-base condition at birth (6,7).…”