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Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy.

Publication ,  Journal Article
Silverman, NS; Watts, DH; Hitti, J; Money, DM; Livingston, E; Axelrod, J; Ernest, JM; Robbins, D; DiVito, MM
Published in: Infect Dis Obstet Gynecol
1998

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications. METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV infection status. RESULTS: For all 39 women, zidovudine (ZDV) therapy was instituted at 13.4 +/- 8.2 weeks, with a second agent (lamivudine [3TC] in 85% of cases) being added at a mean gestational age of 17.6 weeks. Duration of therapy with two agents was 20.6 +/- 10.4 weeks overall, with no women stopping medications because of side effects or toxicity. No significant changes in maternal laboratory values were seen, except for an increase in mean corpuscular volume, over the course of pregnancy. No clinically significant adverse neonatal outcomes were noted, with all but the three preterm newborns leaving hospital with their mothers. Neonatal anemia (hematocrit < 50%) was seen in 62% of newborns, with no children needing transfusion; mild elevations of liver function tests, primarily aspartate aminotransferase, were noted in 58% of newborns tested, though none were clinically jaundiced. Overall rate of neonatal HIV infection was 2.5% (95% confidence interval: 0.1-13.2%). CONCLUSION: Combination antiretroviral therapy during pregnancy with two nucleoside analogs was well-tolerated by mothers and newborns, with no significant short-term toxicities or side effects noted. Surveillance of exposed newborns' hematologic and liver function appears warranted.

Duke Scholars

Published In

Infect Dis Obstet Gynecol

DOI

ISSN

1064-7449

Publication Date

1998

Volume

6

Issue

6

Start / End Page

237 / 243

Location

Egypt

Related Subject Headings

  • Zidovudine
  • United States
  • Treatment Outcome
  • Statistics, Nonparametric
  • Prospective Studies
  • Pregnancy Outcome
  • Pregnancy Complications, Infectious
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Lamivudine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Silverman, N. S., Watts, D. H., Hitti, J., Money, D. M., Livingston, E., Axelrod, J., … DiVito, M. M. (1998). Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy. Infect Dis Obstet Gynecol, 6(6), 237–243. https://doi.org/10.1002/(SICI)1098-0997(1998)6:6<237::AID-IDOG3>3.0.CO;2-E
Silverman, N. S., D. H. Watts, J. Hitti, D. M. Money, E. Livingston, J. Axelrod, J. M. Ernest, D. Robbins, and M. M. DiVito. “Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy.Infect Dis Obstet Gynecol 6, no. 6 (1998): 237–43. https://doi.org/10.1002/(SICI)1098-0997(1998)6:6<237::AID-IDOG3>3.0.CO;2-E.
Silverman NS, Watts DH, Hitti J, Money DM, Livingston E, Axelrod J, et al. Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy. Infect Dis Obstet Gynecol. 1998;6(6):237–43.
Silverman, N. S., et al. “Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy.Infect Dis Obstet Gynecol, vol. 6, no. 6, 1998, pp. 237–43. Pubmed, doi:10.1002/(SICI)1098-0997(1998)6:6<237::AID-IDOG3>3.0.CO;2-E.
Silverman NS, Watts DH, Hitti J, Money DM, Livingston E, Axelrod J, Ernest JM, Robbins D, DiVito MM. Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy. Infect Dis Obstet Gynecol. 1998;6(6):237–243.
Journal cover image

Published In

Infect Dis Obstet Gynecol

DOI

ISSN

1064-7449

Publication Date

1998

Volume

6

Issue

6

Start / End Page

237 / 243

Location

Egypt

Related Subject Headings

  • Zidovudine
  • United States
  • Treatment Outcome
  • Statistics, Nonparametric
  • Prospective Studies
  • Pregnancy Outcome
  • Pregnancy Complications, Infectious
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Lamivudine