{"id":14033,"date":"2010-10-01T10:42:40","date_gmt":"2010-10-01T10:42:40","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=14033"},"modified":"2012-07-26T21:30:57","modified_gmt":"2012-07-26T21:30:57","slug":"low-birth-weight-associated-with-haart-in-pregnancy-in-zambia","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/14033","title":{"rendered":"Low birth weight associated with HAART in pregnancy in Zambia"},"content":{"rendered":"<p><strong>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p>Investigations of the risk of preterm delivery (PTD) and low birth weight &lt;2.5kg (LBW) associated with antiretroviral use (particularly protease inhibitors) in pregnancy have yielded conflicting results both in resource limited and well-resourced settings.<\/p>\n<p>Results were presented from a Zambian study authored by Michael Silverman and colleagues looking at the association with lopinavir\/r (LPV\/r). [1] Its name, The Aluvia study, perhaps reveals, that it was conducted in association with Abbott, the innovator manufacturer of the drug.<\/p>\n<p>This was a prospective study of LPV\/r plus AZT and 3TC taken twice daily at the standard dose started between 14 and 30 weeks of gestation in 280 Zambian women who planned to breastfeed.<\/p>\n<p>The investigators compared these results with historical data from the Zambia Exclusive Breastfeeding Study (ZEBS), conducted at the same location but at a time when HAART was unavailable. Almost all (99.3%) the women in ZEBS received single dose nevirapine (NVP) prophylaxis.<\/p>\n<p>At the time of the analysis, 200 women had delivered 206 live infants and six week HIV DNA PCR results were available for 158 infants, out of which two (1.3%) were diagnosed with HIV.<\/p>\n<p>The combined rate of HIV-infection at six weeks and mortality at three months post partum was 8\/153 (5.2%) compared to 144\/958 (5.2%) in ZEBS, p&lt;0.001.<\/p>\n<p>They reported a mean birth weight for the Aluvia cohort of 2.9kg (SD 0.5) with a LBW incidence of 35\/206 (16.9%) compared to 105\/937 (11.2%) in ZEBS, p=0.02.<\/p>\n<p>There were no significant differences in maternal risk factors for LBW (CD4 &lt;350 cells\/mm3, anaemia, multiple birth, febrile illness). When they compared the women with LBW and non-LBW infants in the Aluvia group the investigators reported no differences in potential risk factors (maternal CD4 count, hypertension, other infections, anaemia, diabetes, malaria) apart from a higher incidence of multiple births in the LBW group (4\/33<br \/>\nvs 1\/167, p&lt;0.01).<\/p>\n<p>They concluded that the LPV\/r regimen does appear to be associated with LBW in this cohort, but that (unsurprisingly) the transmission rate is lower than that with single dose NVP.<\/p>\n<p>Note: this article is only a summary of the abstract.<\/p>\n<h2>comment<\/h2>\n<p><strong>These data are consistent with observations in Europe and Botswana.<\/strong><\/p>\n<p>Ref: Silverman MS et al. Low birthweight (LBW) associated with antepartum HAART in Zambia. 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), 12\u009615 September 2010, Boston. Poster abstract H-1662.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base Investigations of the risk of preterm delivery (PTD) and low birth weight &lt;2.5kg (LBW) associated with antiretroviral use (particularly protease inhibitors) in pregnancy have yielded conflicting results both in resource limited and well-resourced settings. Results were &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3,35],"tags":[104],"class_list":["post-14033","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","category-pmtct-and-maternal-health","tag-icaac-50th-2010"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/14033","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=14033"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/14033\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=14033"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=14033"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=14033"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}