Immunological response to highly active antiretroviral therapy following treatment for prevention of mother to child transmission of HIV-1: a study in Côte dIvoireReport as inadecuate




Immunological response to highly active antiretroviral therapy following treatment for prevention of mother to child transmission of HIV-1: a study in Côte dIvoire - Download this document for free, or read online. Document in PDF available to download.

Journal of the International AIDS Society

, 13:28

First Online: 02 August 2010Received: 17 December 2009Accepted: 02 August 2010

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-mm IQR: 210-466 in 200 women who had undergone 36-month follow-up visits; +359 cells-mm IQR: 222-491 in 88 women not exposed to PMTCT antiretrovirals; and +363 cells-mm 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.

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Author: Didier K Ekouevi - Patrick A Coffie - Marie-Laure Chaix - Besigin Tonwe-Gold - Clarisse Amani-Bosse - Valériane Leroy - E

Source: https://link.springer.com/



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