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Viral Suppression and Resistance in a Cohort of Perinatally-HIV Infected (PHIV+) Pregnant Women.
Cruz, Maria Letícia; Santos, Edwiges; Benamor Teixeira, Maria de Lourdes; Poletti, Monica; Sousa, Carolina; Gouvea, Maria Isabel; Nielsen-Saines, Karin; João, Esaú.
Afiliação
  • Cruz ML; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. mleticia@diphse.com.br.
  • Santos E; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. edwigesmotta@yahoo.com.br.
  • Benamor Teixeira Mde L; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. mlbenamor@hotmail.com.
  • Poletti M; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. monipoletti@hotmail.com.
  • Sousa C; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. cacau.nandes@gmail.com.
  • Gouvea MI; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. bebelsgouvea@uol.com.br.
  • Nielsen-Saines K; School of Medicine, David Geffen University of California, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. KNielsen@mednet.ucla.edu.
  • João E; Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil. esaujoao@gmail.com.
Article em En | MEDLINE | ID: mdl-27338425
Our objective was to describe viral suppression and antiretroviral (ARV) resistance mutations in an ongoing cohort of perinatally-infected HIV+ (PHIV+) pregnant women. Descriptive analysis was performed using SPSS 18.0. From 2011 to 2014, we followed 22 PHIV+ pregnant women. Median age at prenatal entry was 19 years (Interquartile range (IQR) 17.6-21.0); 86% had an AIDS diagnosis; 81% had disclosed their HIV status to partner 11. The median age at HIV diagnosis was 8.3 y (IQR 4.0-13.6), the median age at sexual debut was 16 years (IQR 14-18). At the time of prenatal care initiation, four (18%) were on their first antiretroviral treatment (ART), eight (36%) in their second regimen and nine (41%) in their third regimen or beyond, and one had no data. Seventeen of 22 (77%) had HIV-viral load (VL) > 50 copies/mL at prenatal care entry, 16 had a genotyping exam performed. Seventeen of 22 PHIV+ had VL results near delivery: 7/17 (41%) had VL < 50 copies/mL. Among those who had genotyping at prenatal entry, 11/16 (69%) had mutations associated with ARV resistance. The most frequent major mutations were K103N, M184V, T215, M41L, D67N at reverse transcriptase gene and M46, I54V and V82A at protease gene. No vertical transmissions occurred. Management of pregnancy among PHIV+ is challenging. Individualized ART are needed to achieve viral suppression in a highly ART-exposed subpopulation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Infecções por HIV / Assistência Perinatal / Transmissão Vertical de Doenças Infecciosas / Fármacos Anti-HIV / Carga Viral / Resistência à Doença Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: Int J Environ Res Public Health Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Infecções por HIV / Assistência Perinatal / Transmissão Vertical de Doenças Infecciosas / Fármacos Anti-HIV / Carga Viral / Resistência à Doença Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: Int J Environ Res Public Health Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça