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Antiretrovirals
Improve Pregnancy Outcomes in HIV Positive Women
Use
of antiretroviral therapy (ART) during pregnancy
in HIV-infected women is associated with improved obstetric
outcome and little maternal toxicity, according to the results of
a large study reported in the April 1st issue of the Journal
of the Acquired Immunodeficiency Syndromes.
Dr.
Ruth E. Tuomala of Brigham and Women's Hospital, Boston, analyzed
data on ART use during pregnancy in more than 2500 HIV-infected
women enrolled in the Women and Infants Transmission Study. ART
use at or before 25 weeks gestation was deemed to be early and treatment
at 32 weeks or at delivery was considered to be late.
Overall,
ART use was "independently associated with few maternal complications,"
which included anemia
(odds ratio, 1.6). The late use of ART was associated with
maternal
diabetes (odds ratio, 3.5). There was also an increased
risk (odds ratio, 7.9) of delivery at less than 37 weeks with late
use of ART not containing zidovudine
[AZT; Retrovir].
Among
beneficial effects of late use of ART containing zidovudine was
a decreased risk of stillbirth and delivery at less than 37 weeks
(odds ratio, 0.06).
Early
or late use of ART containing nucleoside
reverse transcriptase inhibitors, but not zidovudine,
was associated with a reduced risk of delivery at less than 32 weeks
(odds ratio, 0.3).
The
investigators conclude that the "benefits of ART continue to
outweigh observed risks."
04/06/05
J
Acquir Immune Defic Syndr 2005;38:449-473.
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