Pregnancies Among the First Generation of Survivors of Perinatal HIV Infection.
J Obstet Gynaecol Can
; 42(4): 446-452, 2020 Apr.
Article
em En
| MEDLINE
| ID: mdl-31882286
ABSTRACT
OBJECTIVE:
Little is known about pregnancy outcomes among women who have acquired human immunodeficiency virus (HIV) through perinatal infection and survived into adulthood. The objectives of this study were to describe pregnancy outcomes among women with perinatal HIV infection (PHIV) in Canada and to identify potential challenges in the prevention of perinatal HIV transmission in this population.METHODS:
A retrospective review of all pregnancies among women with PHIV who were previously followed as children at two tertiary care centres in Montréal, Québec, was conducted. Data were extracted from pediatric and obstetrical records.RESULTS:
There were 21 pregnancies among 11 women, and 18 of these pregnancies were unintentional. Mean age at first pregnancy was 19.5 years (range 15-29 years). At the first prenatal visit, 79% had a detectable viral load, 36% were immunosuppressed (CD4 T cell count <200 mm3), and only 36% were receiving antiretroviral therapy (ART). At the time of delivery, although all were prescribed ART, 50% of these women still had a detectable viral load, and 36% remained immunosuppressed. All of the women harboured mutations conferring drug resistance to zidovudine and lamivudine, and the majority (73%) were also resistant to nevirapine. None of the infants were HIV infected, although all received prophylaxis with agents to which their mother's virus was resistant.CONCLUSION:
Unplanned pregnancies, difficulties with adherence to ART, and drug resistance were identified challenges in the management of pregnancies among women with PHIV. This study highlights a gap in the reproductive counselling of adolescents with PHIV and the need for close follow-up and adherence support during pregnancy in this population.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Infecciosas na Gravidez
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Infecções por HIV
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Fármacos Anti-HIV
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Sobreviventes de Longo Prazo ao HIV
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Terapia Antirretroviral de Alta Atividade
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Gravidez não Planejada
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Infant
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Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Obstet Gynaecol Can
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2020
Tipo de documento:
Article