Journal article
Antiretroviral Prophylaxis to Prevent Perinatal HIV Transmission in St. Petersburg, Russia: Too Little, Too Late
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol.54(3), pp.304-310
07/01/2010
DOI: 10.1097/QAI.0b013e3181cdaba0
PMID: 20130471
Abstract
Background: We evaluated the influence of type and timing of prophylaxis on perinatal HIV transmission in St. Petersburg, Russia.
Methods: We linked surveillance data for 1498 HIV-infected mothers delivering from 2004 to 2007 with polymerase chain reaction data for 1159 infants to determine predictors of transmission.
Results: The overall perinatal transmission rate was 6.3% [73 of 1159, 95% confidence interval (CI) 4.9% to 7.7%]. Among the 12.8% (n = 149) of mother-infant pairs receiving full course (antenatal, intrapartum, postnatal) dual/triple antiretroviral prophylaxis, the transmission rate was 2.7%. Among the 1010 receiving less complete regimens (full course zidovudine, single-dose nevirapine, or incomplete), transmission ranged from 4.1% to 12.2%. Among the 28.9% (330) of mothers initiating antiretroviral drugs <= 20 weeks gestation, perinatal transmission was 1.8%, compared with 4.0%, 8.6%, and 11.3% for those initiating antiretrovirals at 21-28 weeks, 29-42 weeks, or during labor and delivery, respectively (P for trend <0.0001). Compared with those initiating antepartum prophylaxis <= 20 weeks, those initiating antepartum prophylaxis <= 29 weeks (or not at all) had increased transmission odds (adjusted odds ratio: 4.9, 95% CI: 1.8 to 12.9; odds ratio: 5.1, 95% CI: 2.0 to 13.1, respectively).
Conclusions: In St. Petersburg, the potential for further reductions in perinatal transmission is evident, given low transmission among women receiving early combination prophylaxis.
Details
- Title: Subtitle
- Antiretroviral Prophylaxis to Prevent Perinatal HIV Transmission in St. Petersburg, Russia: Too Little, Too Late
- Creators
- Susan D. Hillis - Centers for Disease Control and PreventionElena Kuklina - Northrop GrummanNatalia Akatova - Elizabeth Glaser Pediatric AIDS FoundationDmitry M. Kissin - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHD, Atlanta, GA 30333 USAElena N. Vinogradova - City Clinical Oncology CenterAza G. Rakhmanova - City Hlth Comm, St Petersburg, RussiaElena Stepanova - City Clinical Oncology CenterDenise J. Jamieson - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHD, Atlanta, GA 30333 USAJoanna Robinson - Elizabeth Glaser Pediatric AIDS FoundationCharles Vitek - Ctr Dis Control & Prevent, Global AIDS Program, Moscow, RussiaWilliam C. Miller - Office of Infectious Diseases
- Resource Type
- Journal article
- Publication Details
- JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol.54(3), pp.304-310
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/QAI.0b013e3181cdaba0
- PMID
- 20130471
- ISSN
- 1525-4135
- eISSN
- 2331-6993
- Number of pages
- 7
- Grant note
- Johnson and Johnson; Johnson & Johnson; Johnson & Johnson USA USAID, Russia; United States Agency for International Development (USAID) Elizabeth Glaser Pediatric AIDS Foundation
- Language
- English
- Date published
- 07/01/2010
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446447202771
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