Pregnancy in HIV vertically infected adolescents and young women: a new generation of HIV-exposed infants

Cruz, Maria Letícia Santos; Cardoso, Claudete Aparecida Araújo; Joao, Esau C; Gomes, Ivete Martins; Abreu, Thalita; Oliveira, Ricardo Hugo de; Machado, Elizabeth S.; Dias, Ilda R.; Rubini, Norma M.; Succi, Regina M.

doi:10.1097/qad.0b013e32833e50d4

Cited by 29 publications

(27 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence shows that PHIV pregnant women are more immunosuppressed than their NPHIV counterparts. Several studies reported similarly low CD4 cell counts both before (mean initial CD4 cell count 144-314 cells/mm 3 ) [13, 17, 18] and during the pregnancy (136-394 cells/mm 3 ) [14, 15, 17, 18, 30, 32] in PHIV women as seen in our cohort. Our finding of decreased rates of maternal virologic suppression at delivery in PHIV women is also consistent with other reports.…”

Section: Discussionsupporting

confidence: 82%

“…Our finding of decreased rates of maternal virologic suppression at delivery in PHIV women is also consistent with other reports. [13-15, 17, 18] Not unlike our results, a number of studies have reported increased rates of LBW [13, 15] and similar median BWs (2667-2688g) of children born to PHIV women. [14, 17] The overall rate of preterm birth in our cohort (22.4%) was comparable to rates found in the U.S. among HIV-infected pregnant women (18-22%) [33, 34] as well as reported rates in PHIV women (13.3 – 36%) [12-14, 16, 17].…”

Section: Discussionsupporting

confidence: 64%

“…[1-3] As these long-term survivors are achieving pregnancies, maternal immunological alterations associated with chronic HIV infection and inflammation, [4, 5] as well as maternal behavioral, [6, 7] neurocognitive, [8] and metabolic complications [9] from long-term HIV and antiretroviral (ARV) exposure present a growing concern for a potential impact on the developing fetus/infant. To date, limited information exists on neonatal outcomes of infants born to perinatally HIV-infected (PHIV) pregnant women [10-15]. In contrast to non-perinatally HIV-infected (NPHIV) pregnant women, PHIV women have been observed to have poorer immunologic status throughout pregnancy,[16-18] lower rates of viral suppression at delivery,[13, 14, 17] and higher rates of low birth weight (LBW) (<2500 g) [13] and small-for-gestational age (SGA)[10] outcomes in their infants.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Growth patterns in the first year of life differ in infants born to perinatally vs. nonperinatally HIV-infected women

Jao¹,

Agwu

Mhango³

et al. 2015

Aids

View full text Add to dashboard Cite

Objective To compare growth patterns in the first year of life between children born to perinatally HIV-infected (PHIV) vs. non-perinatally HIV-infected (NPHIV) women in the U.S. Design Retrospective cohort study of HIV-infected pregnant women who received care and delivered a liveborn at two urban tertiary centers from January 2004 - March 2012. Methods We collected data via chart review on demographics, behavioral risk factors, HIV clinical markers, combination antiretroviral therapy (cART), mode of HIV acquisition, pregnancy outcomes, and infant anthropometrics on study subjects. Mixed effects models were used to assess the association between maternal mode of HIV acquisition and weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z-scores. Results Of 152 pregnancies evaluated, 32 and 120 infants were born to 25 PHIV and 99 NPHIV women respectively. Infants of PHIV women exhibited lower mean WAZ and LAZ throughout the first year of life in unadjusted analyses. After adjusting for potential confounders, the relationship between PHIV & LAZ persisted (β=−0.54, p=0.026). Small for gestational age for each birth anthropometric parameter [birth length, birth weight, and both birth length and weight] was associated with decreased LAZ (β=−0.48, p=0.007), WAZ (β=−0.99, p<0.001) and WLZ (β=−0.36, p=0.027) respectively. A delivery HIV RNA level <400 copies/mL was associated with increased WAZ & WLZ (β=0.43, p=0.015; β=0.38, p=0.021). Conclusions Infants of PHIV women may remain at persistently decreased lengths throughout the first year of life. Further studies aimed at understanding intrauterine and environmental factors in PHIV women are warranted.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Growth patterns in the first year of life differ in infants born to perinatally vs. nonperinatally HIV-infected women

Jao¹,

Agwu

Mhango³

et al. 2015

Aids

View full text Add to dashboard Cite

show abstract

“…Reports from Europe [3,4], Puerto Rico [5], India [6], USA [7-10], and Brazil [11] describe favourable maternal and neonatal outcomes, with a MTCT rate varying from 0 to 7.7%, detected in cases of poor adherence to therapy [10]. …”

Section: Introductionmentioning

confidence: 99%

The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection

et al. 2014

View full text Add to dashboard Cite

BackgroundIn the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.MethodsA description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.ResultsTwenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2–6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275–522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36–38, median birth weight: 2550 grams, IQR 2270 – 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 – 42), with no adverse events reported. No child acquired HIV-1 infection.ConclusionsDespite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

show abstract

“…PHIV adolescents start their sexual life at approximately the same age as the HIV-uninfected population [48,49] . Studies on pregnancy showed that its progression and outcomes are similar among PHIV women and women with sexually transmitted HIV, except for the proportion of women with undetectable viral load close to labor and delivery, which is lower among PHIV women [50][51][52] .…”

Section: Reproductive Healthmentioning

confidence: 99%

Perinatally infected adolescents living with human immunodeficiency virus (perinatally human immunodeficiency virus)

Cruz

Cardoso

2015

WJV

View full text Add to dashboard Cite

Pregnancy in HIV vertically infected adolescents and young women: a new generation of HIV-exposed infants

Cited by 29 publications

References 15 publications

Growth patterns in the first year of life differ in infants born to perinatally vs. nonperinatally HIV-infected women

Growth patterns in the first year of life differ in infants born to perinatally vs. nonperinatally HIV-infected women

The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection

Perinatally infected adolescents living with human immunodeficiency virus (perinatally human immunodeficiency virus)

Contact Info

Product

Resources

About