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Brief Report: Impact of Antiretroviral Regimen on Pregnancy and Infant Outcomes in Women With HIV/ HBV Coinfection.
Kiweewa, Flavia Matovu; Tierney, Camlin; Butler, Kevin; Peters, Marion G; Vhembo, Tichaona; Moodley, Dhayendre; Govender, Vani; Mohtashemi, Neaka; Ship, Hannah; Musoke, Philippa; Dula, Dingase; George, Kathy; Chakhtoura, Nahida; Fowler, Mary G; Currier, Judith S; Bhattacharya, Debika.
Afiliação
  • Kiweewa FM; Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda.
  • Tierney C; Department of Epidemiology and Biostatistics, Makerere University School of Public Health, College of Health Sciences, Kampala, Uganda.
  • Butler K; Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.
  • Peters MG; Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.
  • Vhembo T; Department of Medicine, Feinberg School of Medicine, Northwestern University CRS, Chicago, IL.
  • Moodley D; Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
  • Govender V; Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Nelson Mandela School of Medicine, Durban, South Africa.
  • Mohtashemi N; Centre for the AIDS Programme of Research in South Africa, Congella, South Africa.
  • Ship H; Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA.
  • Musoke P; University of Miami Miller School of Medicine, Miami, FL.
  • Dula D; Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda.
  • George K; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University.
  • Chakhtoura N; Centre for AIDS Research in South Africa and Department of Obstetrics and Gynecology, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa.
  • Fowler MG; Family Health International 360, Durham, NC.
  • Currier JS; National Institutes of Health (NIH), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD; and.
  • Bhattacharya D; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
J Acquir Immune Defic Syndr ; 91(1): 79-84, 2022 09 01.
Article em En | MEDLINE | ID: mdl-35621877
BACKGROUND: There are limited data on the impact of antenatal antiretroviral regimens (ARV) on pregnancy and infant outcomes in HIV/HBV coinfection. We compared outcomes among 3 antenatal antiretroviral regimens for pregnant women with HIV/HBV. METHODS: The PROMISE study enrolled ARV-naive pregnant women with HIV. Women with HBV were randomized to (no anti-HBV)-zidovudine (ZDV) + intrapartum nevirapine and 1 week of tenofovir disoproxil fumarate and emtricitabine (TDF-FTC); (3TC)-3TC + ZDV + LPV/r; or (FTC-TDF)-FTC + TDF + LPV/r. Pairwise group comparisons were performed with Fisher exact, t , or log rank tests. Adverse pregnancy outcome (APO) was a composite of low birth weight, preterm delivery, spontaneous abortion, stillbirth, or congenital anomaly. RESULTS: Of 138 women with HIV/HBV, 42, 48, and 48 were analyzed in the no anti-HBV, 3TC, and FTC-TDF arms. Median age was 27 years. APOs trended lower in the no anti-HBV (26%) vs 3TC (38%), and FTC-TDF arms (35%), P ≥ 0.25). More infant deaths occurred among the FTC-TDF [6 (13%)] vs no anti-HBV [2 (5%)] and 3TC [3 (7%)] arms. There were no differences in time-to-death, HIV-free survival, birth or one-year WHO Z-score length-for-age, and head circumference. Hepatitis B e antigen (HBeAg) was associated with an increased risk of APO, 48% vs 27% (odds ratio 2.79, 95% confidence interval: 1.19 to 6.67, post hoc ). CONCLUSION: With HBV/HIV coinfection, the risk of an APO was increased with maternal ARV compared with ZDV alone, although the differences were not statistically significant. Maternal HBeAg was associated with a significantly increased risk of APO. Infant mortality was highest with FTC + TDF + LPV/r. Early assessment of HBeAg could assist in identifying high-risk pregnancies for close monitoring.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV / Coinfecção Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV / Coinfecção Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article