Combination antiretroviral therapy with protease inhibitors in HIV-infected pregnancy

Chi P. Dola 1 , Rubina Khan 2 , Nathaniel DeNicola 1 , Mahin Amirgholami 1 , Tara Benjamin 1 , Azad Bhuiyan 3  and Sherri Longo 2
  • 1 Department of Obstetrics and Gynecology, Tulane Health Sciences Center, Tulane University School of Medicine, New Orleans, LA, USA
  • 2 Department of Obstetrics and Gynecology, Ochsner Medical Center – Internal Medicine, New Orleans, LA, USA
  • 3 Department of Epidemiology, Jackson State University, Jackson, MS, USA

Abstract

Objective: To evaluate the possible association between protease inhibitor (PI) and premature birth and low birth-weight in HIV-infected pregnancies.

Materials and methods: Data were collected retrospectively for maternal and pregnancy characteristics, antiretroviral medication, lowest CD4 count and highest viral load during pregnancy, and pregnancy outcomes. χ2 Analysis, Student’s t-test, and multiple logistic regression analysis were performed.

Results: Data from 161 HIV-infected women who delivered singleton gestation were analyzed. Fifty-three received an antepartum regimen with PI, 84 received a regimen without PI, and six did not receive antepartum treatment. The mean estimated gestational age (EGA)±SD at delivery was 37.7±3.2 weeks. The premature birth rate was 18.4%. No difference was detected between women receiving the antiretroviral regimen including PI and those on the regimen without PI or on no antepartum medication with regard to: EGA±SD at delivery (37.7±3.2 vs. 37.6±3.1 weeks, respectively, P=0.87), rate of premature birth (14% vs. 20.6%, respectively, P=0.32) and low birth-weight (12.5% vs. 20.2%, respectively, P=0.25). In multiple logistic regression analysis, PI was not associated with premature birth or low birth-weight.

Conclusion: Women receiving antiretroviral therapy with PI have a similar rate of premature birth and low birth-weight as women receiving antiretroviral therapy without PI or on no medication.

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