Birth Outcome in HIV Vertically-Exposed Children in Two Romanian Centers
BACKGROUND:
The
Romanian HIV epidemic is characterized by a high prevalence among children born
in the late '80s, perinatally infected. The impact of long-term treatment on
their offspring is unknown. We evaluated the influence of prenatal care on the
rate of premature birth among the HIV-exposed children of heavily treated
HIV-infected mothers in two Romanian centers.
METHODS:
We
retrospectively analyzed data on all patients born by HIV-infected mothers
between 2006 and 2012 followed up in two main regional centers. We compared the
rate of premature birth and the differences between the sites regarding
children and maternal demographic characteristics and antiretroviral exposure
in pregnant women.
RESULTS:
A total
of 358 children born to 315 women were enrolled between 2006-2012, 262 children
from the National Institute for Infectious Diseases "Prof. Dr. Matei
Balş" Bucharest (NIID) and 96 children from the Clinical Infectious
Diseases Hospital Constanţa (IDHC). Gender rate in newborns and mean age in
mothers were similar. We recorded statistically significant differences between
centers in the rate of HIV vertical transmission (16.8% vs. 6.2%, p=0.002) and
prematurity (25.2 vs. 14.6%, p=0.023). The most used antiretroviral combination
during pregnancy in IDHC was boosted lopinavir and fixed dose
zidovudine-lamivudine (66% of cases), while in NIID a greater diversity of
antiretrovirals were used. Women from IDHC were more frequently treated during
pregnancy (83.3% vs. 68.6%, p=0.004). HCV coinfection and illegal drug use were
associated with prematurity in the NIID cohort (p=0.037, p=0.024).
CONCLUSION:
We
found a higher rate of premature birth and HIV infection in NIID. In IDHC we
found a higher rate of low birth weight in children and a higher rate of
heavily treated women. Prematurity was associated with hepatitis C infection
and illegal drug use in the NIID cohort.
Below: Distribution of cases over the study period in two Romanian centers
By: Tudor AM1, Mărdărescu M2, Petre C3, Neagu Drăghicenoiu R3, Ungurianu R3, Tilişcan C4, Oţelea D5, Cambrea SC6, Tănase DE7, Schweitzer AM8, Ruţă S9.
- 1MD, PhD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
- 2MD, PhD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
- 3MD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
- 4MD, PhD, National Institute for Infectious Diseases "Prof Dr Matei Balş" Carol Davila, University of Medicine and Pharmacy, Bucharest, Romania.
- 5MD, PhD, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
- 6MD, PhD Pediatric Department, Infectious Diseases Hospital Constanţa, Faculty of Medicine, Ovidius University of Constanţa, Romania.
- 7MD, Pediatric Department Infectious Diseases Hospital Constanţa, Romania.
- 8Psychologist, Executive Director Baylor Black Sea Foundation, Constanţa, Romania.
- 9MD, PhD, Ştefan S. Nicolau Institute of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
- Germs. 2015 Dec 2;5(4):116-24. doi: 10.11599/germs.2015.1079. eCollection 2015.
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