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Protease inhibitor use in 233 pregnancies
Anne B Morris1, Ana Rua Dobles, Susan Cu-Uvin
1Community Research Initiative of New England, Springfield, MA 01107, USA. amorris@crine.org
Journal of Acquired Immune Deficiency Syndromes (1999)
|August 27, 2005
Summary
Protease inhibitors (PIs) used during pregnancy for HIV-infected women showed generally safe outcomes for mothers and infants. Perinatal HIV transmission was low, and prematurity rates were comparable to those not using PIs.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Pediatrics
Background:
- Most highly active antiretroviral therapy (HAART) regimens in the US for pregnant, HIV-infected women include protease inhibitors (PIs).
- Understanding the specific impact of PIs, rather than all HAART, during pregnancy is crucial.
- Ongoing prospective trials are evaluating HAART use during pregnancy.
Purpose of the Study:
- To assess the effects of protease inhibitor (PI) use during pregnancy.
- To evaluate impacts on prematurity, maternal and infant adverse events, and overall infant outcomes.
Main Methods:
- Analysis of 233 pregnancies involving PI use.
- Inclusion of multiple births (twins and triplets).
- Multiple regression analysis to identify associations with PI type and initiation timing.
Main Results:
- Low perinatal HIV transmission rate of 0.9% (2 of 221 infants).
- Prematurity rate of 22.0% (<37 weeks' gestation), including multiple gestations.
- Adverse maternal, obstetric, and infant events possibly related to PIs were infrequent.
Conclusions:
- Protease inhibitors (PIs) appear generally safe for both mothers and infants during pregnancy.
- Observed perinatal transmission rates were low.
- The prematurity rate aligns with previous data from HIV-positive women not on PIs.