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感染艾滋病毒女性的抗逆转录病毒治疗与分娩结局的关系:一项队列研究。

Antiretroviral Therapy in Relation to Birth Outcomes among HIV-infected Women: A Cohort Study.

作者信息

Li Nan, Sando Mary Mwanyika, Spiegelman Donna, Hertzmark Ellen, Liu Enju, Sando David, Machumi Lameck, Chalamilla Guerino, Fawzi Wafaie

机构信息

Department of Global Health and Population, Harvard T.H. Chan School of Public Health (HSPH), Boston, Massachusetts.

Management and Development for Health, Dar es Salaam, Tanzania.

出版信息

J Infect Dis. 2016 Apr 1;213(7):1057-64. doi: 10.1093/infdis/jiv389. Epub 2015 Aug 10.

Abstract

Although the beneficial effects of antiretroviral (ARV) therapy for preventing mother-to-child transmission are indisputable, studies in developed and developing countries have reported conflicting findings on the association between ARV exposure and adverse birth outcomes. We conducted a prospective observational study at 10 human immunodeficiency virus (HIV) care and treatment centers in Dar es Salaam, Tanzania. Multivariate log-binomial regression was used to investigate the associations between ARV use and adverse birth outcomes among HIV-negative HIV-exposed infants. Our findings demonstrate an increased risk of adverse birth outcomes associated with the use of highly active antiretroviral therapy during pregnancy. Further studies are needed to investigate the underlying mechanisms and identify the safest ARV regimens for use during pregnancy.

摘要

尽管抗逆转录病毒(ARV)疗法在预防母婴传播方面的有益效果无可争议,但发达国家和发展中国家的研究报告了关于ARV暴露与不良出生结局之间关联的相互矛盾的结果。我们在坦桑尼亚达累斯萨拉姆的10个人类免疫缺陷病毒(HIV)护理和治疗中心进行了一项前瞻性观察研究。采用多变量对数二项回归来研究HIV阴性但暴露于HIV的婴儿中ARV使用与不良出生结局之间的关联。我们的研究结果表明,孕期使用高效抗逆转录病毒疗法会增加不良出生结局的风险。需要进一步研究以调查潜在机制,并确定孕期使用最安全的ARV治疗方案。

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