Abstract
BackgroundInformation is currently limited on the long-term follow up of HIV-1 infected women who are on highly active antiretroviral therapy (HAART) that contains nevirapine and lamivudine and who were previously exposed to antiretroviral drugs for the prevention of mother to child transmission (PMTCT) of HIV.MethodsWe studied the 36-month immunological response to HAART in HIV-1 infected women in Côte d'Ivoire. The women were previously exposed to antiretroviral drug regimens for PMTCT, including single-dose nevirapine and/or short-course zidovudine with or without lamivudine. All HAART regimens included a non-nucleoside reverse transcriptase inhibitor.ResultsAt 36 months: the median absolute increase in CD4+ T cell count was +359 cells/mm3 (IQR: 210-466) in 200 women who had undergone 36-month follow-up visits; +359 cells/mm3 (IQR: 222-491) in 88 women not exposed to PMTCT antiretrovirals; and +363 cells/mm3 (IQR: 200-464) in 112 women exposed to at least one antiretroviral PMTCT regimen. Overall, 49 (19.8%) of the 247 women who initiated HAART met the immunological failure criteria at least once during follow up. The overall probability of immunological failure was 0.08 (95% CI: 0.12-0.15) at 12 months, and 0.21 (95% CI: 0.16-0.27) at 36 months. No difference was observed according to the presence or absence of resistance mutations to nevirapine or lamivudine in women tested at four weeks postpartum. In addition, at 36 months, 23% of women were lost to follow up, dead or had stopped their treatment.ConclusionsA non-nucleoside reverse transcriptase inhibitor-based antiretroviral regimen, initiated a year or more after PMTCT exposure and that includes nevirapine, remains a good option for at least the first 36 months of treatment.
Highlights
Information is currently limited on the long-term follow up of HIV-1 infected women who are on highly active antiretroviral therapy (HAART) that contains nevirapine and lamivudine and who were previously exposed to antiretroviral drugs for the prevention of mother to child transmission (PMTCT) of HIV
We report the immunological response to HAART at 36 months in women previously exposed to short-course ARV prophylaxis and study factors associated with immunological failure or with immunological failure and death according to the history of PMTCT exposure
Our population consisted of: (1) women never exposed to any treatment for PMTCT; (2) women exposed to single-dose NVP and zidovudine (ZDV) for PMTCT; and (3) women exposed to shortcourse zidovudine and 3TC for PMTCT
Summary
Information is currently limited on the long-term follow up of HIV-1 infected women who are on highly active antiretroviral therapy (HAART) that contains nevirapine and lamivudine and who were previously exposed to antiretroviral drugs for the prevention of mother to child transmission (PMTCT) of HIV. Information is currently limited on the long-term follow-up of HIV-1 infected women who are on highly active antiretroviral therapy (HAART) containing nevirapine (NVP) and lamivudine (3TC) and who were previously exposed to antiretroviral (ARV) drugs for the prevention of mother to child transmission (PMTCT) of HIV [1,2,3,4]. We report the immunological response to HAART at 36 months in women previously exposed to short-course ARV prophylaxis and study factors associated with immunological failure or with immunological failure and death according to the history of PMTCT exposure
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have