艾滋病毒感染妇女的早产:怀孕前cART启动的影响
Cassandra R Duffy1, Julie M Herlihy2,3, Ethan Zulu4
1Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School.
AIDS (London, England)
|July 17, 2024
概括
艾滋病毒感染增加了孕妇早产 (PTB) 的风险. 在怀孕期间开始组合抗逆转录病毒疗法 (cART),特别是怀孕后,进一步提高PTB和妊娠年龄 (SGA) 风险.
科学领域:
- 生殖健康 生殖健康
- 传染性疾病 传染性疾病
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染可能会影响怀孕的结果.
- 了解艾滋病毒阳性孕妇早产 (PTB) 和妊娠年龄小 (SGA) 的风险至关重要.
- 孕产妇免疫激活 (IA) 和联合抗逆转录病毒疗法 (cART) 时间的作用需要进一步研究.
研究的目的:
- 为了比较PTB和SGA的发病率在怀孕妇女和没有艾滋病毒.
- 探索孕产妇IA对这些不良分娩结果的影响.
- 评估cART启动时间对艾滋病毒感染妇女PTB和SGA的影响.
主要方法:
- 在赞比亚卢萨卡进行的前性观察队列研究.
- 1481名孕妇 (艾滋病毒阳性和艾滋病毒阴性) 在怀孕26周之前被录取.
- 收集了母性因素,CD4+,病毒载量,CD8+T细胞IA和出生结果;使用了多变量逻辑回归和调解分析.
主要成果:
- 孕产妇艾滋病毒感染与PTB有显著的相关性 (aOR 1.60) 和中度的SGA (aOR 1.29).
- 怀孕后启动cART显示PTB (aOR 1.77) 和SGA (aOR 1.52) 的风险最高.
- 在考虑艾滋病毒状况时,母亲IA与PTB没有独立相关.
结论:
- 艾滋病毒感染是早产的重要危险因素.
- 在怀孕期间启动cART,特别是在受孕后,与PTB和SGA的风险增加有关.
- 开始cART的时间代表了改善艾滋病毒感染妇女怀孕结果的潜在可修改因素.
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