Maternal Toxicity and Pregnancy Complications in Women Receiving Antiretroviral Therapy

The purpose of this study was to evaluate rates of maternal toxicity, pregnancy complications, and peripartum morbidity by type and duration of antiretroviral therapy (ART) during pregnancy.

The Pediatric AIDS Clinical Trials Group (PACTG) Protocol 316 (PACTG 316) study evaluated the addition of intrapartum/neonatal nevirapine (Viramune) to background ART to reduce perinatal transmission of human immunodeficiency virus-1 (HIV-1).

For this secondary analysis, women were categorized into one of six groups on the basis of ART during pregnancy (monotherapy [monoRx], combination without protease inhibitor [PI], combination with PI), and start time (early: before or during first trimester; late: second or third trimester).

Results

One thousand four hundred seven women were included: 288 monoRx late, 34 monoRx early, 327 combo, no PI late, 175 combo, no PI early, 320 combo, PI late, and 263 combo, PI early.

Symptoms and laboratory abnormalities of moderate grade or more occurred in less than 5% of women. Only gestational diabetes (highest in combo PI early) varied significantly by therapy group.

The authors conclude, “In HIV-infected women receiving prenatal care and ART, adverse events were uncommon.”

National Institute of Child Health and Human Development, Bethesda, MD.

03/05/04

Reference
D H Watts and others (for the PACTG Team). Maternal toxicity and pregnancy complications in human immunodeficiency virus-infected women receiving antiretroviral therapy: PACTG 316. American Journal of Obstetrics and  Gynecology 190(2): 506-516. February 2004.