{"id":10238,"date":"2010-04-02T12:27:34","date_gmt":"2010-04-02T12:27:34","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=10238"},"modified":"2013-08-08T12:03:09","modified_gmt":"2013-08-08T12:03:09","slug":"pregnancy-outcomes-in-women-using-non-azt-haart-in-europe","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/10238","title":{"rendered":"Pregnancy outcomes in women using non-AZT HAART in Europe"},"content":{"rendered":"

Polly Clayden, HIV\u00a0i-Base<\/strong><\/p>\n

AZT is the only antiretroviral licensed for use in pregnancy. In resource rich settings AZT-containing regimens are becoming less and less common and in\u00a0turn increasing numbers of women are becoming pregnant while receiving non AZT-containing HAART, or initiating non-AZT-containing HAART in pregnancy.<\/strong><\/p>\n

A poster at authored by Shema Tariq and colleagues reported findings from an investigation into the risk of detectable maternal viral load (VL) at\u00a0delivery, congenital abnormality and mother to child transmission (MTCT) in pregnancies among women receiving HAART containing and not containing AZT. [1]<\/p>\n

This analysis combined data from the National study of HIV in Pregnancy and Childhood (NSHPC) and the European Collaborative Study (ECS).<\/p>\n

All live singleton births from 2000 to 2009 with >14 days of HAART in pregnancy were included. The investigators used logistic regression to estimate\u00a0adjusted odds ratios (AOR).<\/p>\n

A total of 7353 (6310, NSHPC and 1263, ECS) pregnancies were included, of which 1199\u00a0 (15.8%) were exposed to non-AZT HAART. Of this group, 23.2% and\u00a071.3% were on HAART prior to conception in the AZT and non-AZT groups respectively. Exposure to non-AZT HAART increased over time: 2000\u00962002 19.6% vs\u00a017.1%, 2006\u00962009 41.4 vs 58.7% women received AZT vs non-AZT HAART respectively, p<0.01.<\/p>\n

Tenofovir and abacavir was the most commonly used non-AZT drug in this cohort; approx 45% and 35% respectively.<\/p>\n

In multivariate analysis the investigators found no evidence of associations between non-AZT HAART and detectable viral load at delivery, risk of\u00a0congenital abnormalities (including in a sub-analysis of pregnancies with 1st trimester exposure or rate of MTCT, see Table 1.<\/p>\n

Table1. Maternal and infant outcomes AZT vs non-AZT HAART multivariate analysis, AOR (95% CI)<\/strong><\/p>\n\n\n\n\n\n\n
<\/td>\nDetectable maternal VL at delivery<\/td>\nCongenital abnormalities (all pregnancies)<\/td>\nCongenital abnormalities (1st trimester HAART
\nexposure)<\/td>\n		MTCT<\/td>\n<\/tr>\n
n<\/td>\n4212<\/td>\n7353<\/td>\n1930<\/td>\n6111<\/td>\n<\/tr>\n
AZT HAART (ref. group)<\/td>\n1<\/td>\n1<\/td>\n1<\/td>\n1<\/td>\n<\/tr>\n
Non-AZT HAART<\/td>\n0.90 (0.73-1.11); p=0.33<\/td>\n0.95 (0.64\u00961.41); p=0.80<\/td>\n0.76
\n(0.46\u00961.25); p=0.28<\/td>\n		1.81 (0.77\u00964.26); p=0.18<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

The investigators noted that information on maternal VL at delivery was\u00a0missing for 45% of pregnancies however the proportions of missing data were similar for both groups. Additionally HIV status was not yet reported for 20%\u00a0of infants, mainly those born recently. They suggested that this is unlikely to introduce bias.<\/p>\n

The investigators described these results as reassuring and that continued monitoring of pregnancy outcomes and longer term consequences of in utero\u00a0exposure to these antiretroviral drugs is required.<\/p>\n

Ref: Tariq S et al.\u00a0 Pregnancy outcomes in HIV-infected women using non-zidovudine HAART in Europe: 2000 to 2009. 17th CROI, San Francisco, 2010.\u00a0 Poster\u00a0abstract 895.
\nhttp:\/\/www.retroconference.org\/2010\/Abstracts\/37281.htm<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Polly Clayden, HIV\u00a0i-Base AZT is the only antiretroviral licensed for use in pregnancy. In resource rich settings AZT-containing regimens are becoming less and less common and in\u00a0turn increasing numbers of women are becoming pregnant while receiving non AZT-containing HAART, or …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,35],"tags":[64],"class_list":["post-10238","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pmtct-and-maternal-health","tag-croi-2010"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/10238","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=10238"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/10238\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=10238"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=10238"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=10238"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}