Use of enhanced perinatal human immunodeficiency virus surveillance methods to assess antiretroviral use and perinatal human immunodeficiency virus transmission in the United States, 1999-2001

Am J Obstet Gynecol. 2007 Sep;197(3 Suppl):S33-41. doi: 10.1016/j.ajog.2007.03.081.

Abstract

Objective: Significant reductions in perinatal human immunodeficiency virus (HIV) transmission have been demonstrated in which the HIV-infected mothers and their HIV-exposed infants receive prenatal, intrapartum, and neonatal antiretroviral therapy.

Study design: We used data that were collected through the Enhanced Perinatal Surveillance system for HIV-exposed singleton births that occurred 1999-2001 in 24 sites.

Results: The overall infant infection rate for the 3 years was 4.7%. Compared with zidovudine monotherapy, those patients who received zidovudine with other drugs that included a protease inhibitor and those who received zidovudine and other drugs with no protease inhibitor were less likely to have an infected infant (adjusted odds ratio, 0.4 [95% CI, 0.3-0.07]; adjusted odds ratio, 0.5 [95% CI, 0.3-0.8], respectively).

Conclusion: These data support the current treatment recommendations and show that infants were less likely to be infected when the mothers were given a prenatal antiretroviral therapy regimen that contained zidovudine with additional antiretroviral drugs with or without a protease inhibitor in addition to receiving antiretrovirals during delivery and neonatally.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-HIV Agents / therapeutic use
  • Anti-Retroviral Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • Humans
  • Incidence
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Infectious Disease Transmission, Vertical / statistics & numerical data
  • Population Surveillance*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Protease Inhibitors / therapeutic use
  • Treatment Outcome
  • United States / epidemiology
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents
  • Protease Inhibitors
  • Zidovudine