BACKGROUND: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing. METHODS: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children. RESULTS: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 - 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection. CONCLUSIONS: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.
|Autori:||Carmelina Calitri;Clara Gabiano;Luisa Galli;Elena Chiappini;Carlo Giaquinto;Wilma Buffolano;Orazio Genovese;Susanna Esposito;Stefania Bernardi;Maurizio De Martino;Pier-Angelo Tovo; Osimani P; Larovere D; Ruggeri M; Pession A; Faldella G; Capra F; Pulcini S; Zattoni V; Dedoni M; Aliffi A; Anastasio E; Fiumana E; Gervaso P; Montagnani C; Di Biagio A; Nicolini LA; De Hoffer L; Acutis MS; Bondi E; Erba P; Fabiano V; Ramponi G; Salvini F; Lipreri R; Esposito S; Plebani A; Tagliabue C; Giubbarelli F; Nicastro E; Lo Vecchio A; Buffolano W; Agnese M; Romano A; Giaquinto C; Rampon O; Pennazzato M; Consolini R; Dodi I; Maccabruni A; Genovese O; Palma P; Pontrelli G; Tchidjou H; Olmeo P; Mazza A; Silvestro E; Virano S; Portelli V; Rabusin M; Pellegatta A|
|Titolo:||The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection|
|Anno del prodotto:||2014|
|Digital Object Identifier (DOI):||10.1186/1471-2334-14-277|
|Appare nelle tipologie:||1.1 Articolo in rivista|