Perinatal antiretroviral intensification to prevent intrapartum HIV transmission when antenatal antiretroviral therapy is initiated less than 8 weeks before delivery
Journal of Acquired Immune Deficiency Syndromes Jun 19, 2020
Lallemant M, Amzal B, Sripan P, et al. - Given a high risk of intrapartum infection among infants born to women living with HIV initiating combination antiretroviral therapy (cART) late in pregnancy, researchers here examined if mother/infant perinatal antiretroviral intensification can reduce this risk. They conducted this single-arm Bayesian trial including pregnant women with HIV receiving standard of care antiretroviral prophylaxis in Thailand (maternal antenatal lopinavir-based cART; nonbreastfed infants 4 weeks' postnatal zidovudine). The participants were offered “antiretroviral intensification” (labor single-dose nevirapine plus infant zidovudine-lamivudine-nevirapine for 2 weeks followed by zidovudine-lamivudine for 2 weeks) if their antenatal cART was started ≤ 8 weeks before delivery. None of the 88 mother/infant pairs receiving intensification had intrapartum transmission of HIV. Findings thereby support the effectiveness of performing mother/infant antiretroviral intensification in preventing intrapartum transmission of HIV in pregnant women receiving ≤ 8 weeks antepartum cART.
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