Read Jennifer S, Samuel N M, Parameshwari S, Dharmarajan Shoba, Van Hook Hannah M, Jacob S Mini, Junankar Viju, Bethel James, Xu Jiahong, Stoszek Sonia K
Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-7510, USA.
J Int Assoc Physicians AIDS Care (Chic). 2007 Jun;6(2):125-36. doi: 10.1177/1545109707301248.
The authors assessed acceptance and safety of, and adherence to, perinatal HIV-1 transmission prophylaxis at 2 public hospitals in rural Tamil Nadu, India.
Eligible HIV-1-infected women were offered zidovudine (ZDV) beginning at 28-weeks gestation until delivery. Their infants received ZDV for 6 weeks. A subsequent revision to the protocol added 1 dose of nevirapine (NVP) for mother and infant.
Sixty of 67 women (90%) met inclusion criteria for the cohort study. Thirty-four of 36 eligible women and all 19 eligible live born infants received prophylaxis on study. Infant, but not maternal, adherence to ZDV varied by antiretroviral prophylaxis group (those receiving combined prophylaxis with ZDV and NVP had lower median adherence) (P = .02). Neutropenia (usually transient) was the most common severe adverse event. Only 1 of 5 women with neutropenia possibly related to ZDV permanently discontinued ZDV. ZDV was not discontinued for any infant.
With the exception of neutropenia, usually transient and always without clinical consequences, long-term ZDV (with or without NVP prophylaxis) is well tolerated.
作者评估了印度泰米尔纳德邦农村地区两家公立医院围产期HIV-1传播预防措施的接受度、安全性及依从性。
符合条件的HIV-1感染女性从妊娠28周开始接受齐多夫定（ZDV）治疗直至分娩。她们的婴儿接受6周的ZDV治疗。随后对方案进行修订，为母亲和婴儿增加一剂奈韦拉平（NVP）。
67名女性中有60名（90%）符合队列研究的纳入标准。36名符合条件的女性中有34名以及所有19名符合条件的活产婴儿接受了研究中的预防治疗。婴儿对ZDV的依从性因抗逆转录病毒预防治疗组而异（接受ZDV和NVP联合预防治疗的婴儿中位依从性较低）（P = 0.02），但母亲对ZDV的依从性不存在这种差异。中性粒细胞减少症（通常为暂时性）是最常见的严重不良事件。5名可能与ZDV相关的中性粒细胞减少症女性中只有1名永久性停用了ZDV。没有任何婴儿停用ZDV。
除了通常为暂时性且无临床后果的中性粒细胞减少症外，长期使用ZDV（无论是否联合NVP预防治疗）耐受性良好。
