HIV-infected pregnant women and vertical transmission in Europe since 1986

C. Giaquinto; E. Ruga; A. De Rossi; I. Grosch-Wörner; K. Seel; J. Mok; F. Johnstone; M. C. Garcia-Rodriguez; I. Bates; I. de José; F. Hawkins; C. Ladrón de Gevara; J. Ma Peña; J. Gonzalez Garcia; J. R. Arribas Lopez; F. Asensi-Botet; M. C. Otero; D. Pérez-Tamarit; S. Ridaura; P. Gregori; R. de la Torre; H. Scherpbier; M. Kreyenbroek; K. Boer; A. B. Bohlin; S. Lindgren; A. Ehrnst; B. Anzén; K. Lidman; E. Belfrage; L. Navér; J. Levy; P. Barlow; M. Hainaut; A. Peltier; S. Wibaut; G. Debruyne; A. Ferrazin; D. Bassetti; A. De Maria; C. Gotta; A. Mur; A. Payà; M. Viñolas; M. A. López-Vilchez; P. Martinez-Gómez; R. Carreras; J. Jimenez; O. Coll; C. Fortuny; J. Boguña; M. Casellas Caro; Y. Canet; G. Pardi; M. Ravizza; B. Guerra; M. Lanari; L. Bovicelli; E. Prati; M. Duse; G. Scaravelli; M. Stegagno; M. De Santis; A. E. Semprini; V. Savasi; A. Viganò; F. Ravagni Probizer; A. Maccabruni; A. Bucceri; L. Rancilio; G. P. Taylor; E. G.H. Lyall; Z. Penn; N. H. Valerius; W. Buffolano; P. Martinelli; M. Sansone; C. Tibaldi; N. Ziarati; C. Benedetto; T. Niemieç; A. Horban

doi:10.1097/00002030-200104130-00012

HIV-infected pregnant women and vertical transmission in Europe since 1986

C. Giaquinto, E. Ruga, A. De Rossi, I. Grosch-Wörner, K. Seel, J. Mok, F. Johnstone, M. C. Garcia-Rodriguez, I. Bates, I. de José, F. Hawkins, C. Ladrón de Gevara, J. Ma Peña, J. Gonzalez Garcia, J. R. Arribas Lopez, F. Asensi-Botet, M. C. Otero, D. Pérez-Tamarit, S. Ridaura, P. GregoriR. de la Torre, H. Scherpbier, M. Kreyenbroek, K. Boer, A. B. Bohlin, S. Lindgren, A. Ehrnst, B. Anzén, K. Lidman, E. Belfrage, L. Navér, J. Levy, P. Barlow, M. Hainaut, A. Peltier, S. Wibaut, G. Debruyne, A. Ferrazin, D. Bassetti, A. De Maria, C. Gotta, A. Mur, A. Payà, M. Viñolas, M. A. López-Vilchez, P. Martinez-Gómez, R. Carreras, J. Jimenez, O. Coll, C. Fortuny, J. Boguña, M. Casellas Caro, Y. Canet, G. Pardi, M. Ravizza, B. Guerra, M. Lanari, L. Bovicelli, E. Prati, M. Duse, G. Scaravelli, M. Stegagno, M. De Santis, A. E. Semprini, V. Savasi, A. Viganò, F. Ravagni Probizer, A. Maccabruni, A. Bucceri, L. Rancilio, G. P. Taylor, E. G.H. Lyall, Z. Penn, N. H. Valerius, W. Buffolano, P. Martinelli, M. Sansone, C. Tibaldi, N. Ziarati, C. Benedetto, T. Niemieç, A. Horban

Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health

Research output: Contribution to journal › Article › Research › peer-review

163 Citations (Scopus)

Abstract

Objective: To describe changes over a 15-year period in characteristics and management of HIV-infected pregnant women in Europe. Design: Prospective study. Methods: Analysis of prospective data on 2876 pregnant HIV-infected women and their 3076 infants. Factors examined included maternal socio-demographic, immunological and virological characteristics, antiretroviral therapy and pregnancy outcome. Results: Among women enrolled, the proportion with heterosexual acquisition of infection has increased significantly from 59% (201/342) in 1985-1987 to 69% (327/471) after 1997 while the proportion acquiring HIV through injecting drug use has declined. Overall median CD4 cell count was 440 × 106/l and 41% of women had undetectable viral load at delivery. In 1995 28% (72/256) of mother-child pairs received the full 076 regimen to reduce risk of vertical transmission, rising significantly to 89% (116/130) by 1999. Use of triple therapy started in pregnancy has increased significantly from < 1% (1/153) in 1997 to 44% (47/107) in 1999. Exposure to antiretroviral therapy was not associated with prevalence or pattern of congenital abnormalities (P = 0.88) but was associated with reversible anaemia in the infant (P < 0.002). The elective cesarean section rate has increased from 10% in 1992 to 71% in 1999/2000. The vertical transmission rate declined from 15.5% by 1994 to 2.6% after 1998. In multivariate analysis, adjusting for maternal CD4 cell count, risk of vertical transmission was reduced by 66% (95% confidence interval, 37-82%) with the full 076 regimen and by 60% (95% confidence interval, 33-73%) with elective cesarean section delivery. Conclusions: Changes in treatment of adult HIV disease have affected the management of infected pregnant women. Despite therapeutic and surgical interventions, vertical transmission still occurs. © 2001 Lippincott Williams & Wilkins.

Original language	English
Pages (from-to)	761-770
Journal	AIDS
Volume	15
Issue number	6
DOIs	https://doi.org/10.1097/00002030-200104130-00012
Publication status	Published - 13 Apr 2001

Keywords

AIDS
Antiretroviral therapy
Epidemiology
Pregnancy
Vertical transmission

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Giaquinto, C., Ruga, E., De Rossi, A., Grosch-Wörner, I., Seel, K., Mok, J., Johnstone, F., Garcia-Rodriguez, M. C., Bates, I., de José, I., Hawkins, F., Ladrón de Gevara, C., Ma Peña, J., Gonzalez Garcia, J., Arribas Lopez, J. R., Asensi-Botet, F., Otero, M. C., Pérez-Tamarit, D., Ridaura, S., ... Horban, A. (2001). HIV-infected pregnant women and vertical transmission in Europe since 1986. AIDS, 15(6), 761-770. https://doi.org/10.1097/00002030-200104130-00012

Giaquinto, C. ; Ruga, E. ; De Rossi, A. ; Grosch-Wörner, I. ; Seel, K. ; Mok, J. ; Johnstone, F. ; Garcia-Rodriguez, M. C. ; Bates, I. ; de José, I. ; Hawkins, F. ; Ladrón de Gevara, C. ; Ma Peña, J. ; Gonzalez Garcia, J. ; Arribas Lopez, J. R. ; Asensi-Botet, F. ; Otero, M. C. ; Pérez-Tamarit, D. ; Ridaura, S. ; Gregori, P. ; de la Torre, R. ; Scherpbier, H. ; Kreyenbroek, M. ; Boer, K. ; Bohlin, A. B. ; Lindgren, S. ; Ehrnst, A. ; Anzén, B. ; Lidman, K. ; Belfrage, E. ; Navér, L. ; Levy, J. ; Barlow, P. ; Hainaut, M. ; Peltier, A. ; Wibaut, S. ; Debruyne, G. ; Ferrazin, A. ; Bassetti, D. ; De Maria, A. ; Gotta, C. ; Mur, A. ; Payà, A. ; Viñolas, M. ; López-Vilchez, M. A. ; Martinez-Gómez, P. ; Carreras, R. ; Jimenez, J. ; Coll, O. ; Fortuny, C. ; Boguña, J. ; Casellas Caro, M. ; Canet, Y. ; Pardi, G. ; Ravizza, M. ; Guerra, B. ; Lanari, M. ; Bovicelli, L. ; Prati, E. ; Duse, M. ; Scaravelli, G. ; Stegagno, M. ; De Santis, M. ; Semprini, A. E. ; Savasi, V. ; Viganò, A. ; Ravagni Probizer, F. ; Maccabruni, A. ; Bucceri, A. ; Rancilio, L. ; Taylor, G. P. ; Lyall, E. G.H. ; Penn, Z. ; Valerius, N. H. ; Buffolano, W. ; Martinelli, P. ; Sansone, M. ; Tibaldi, C. ; Ziarati, N. ; Benedetto, C. ; Niemieç, T. ; Horban, A. / HIV-infected pregnant women and vertical transmission in Europe since 1986. In: AIDS. 2001 ; Vol. 15, No. 6. pp. 761-770.

@article{7a6d0fc0ebbf44afbd8abebea44cec4c,

title = "HIV-infected pregnant women and vertical transmission in Europe since 1986",

abstract = "Objective: To describe changes over a 15-year period in characteristics and management of HIV-infected pregnant women in Europe. Design: Prospective study. Methods: Analysis of prospective data on 2876 pregnant HIV-infected women and their 3076 infants. Factors examined included maternal socio-demographic, immunological and virological characteristics, antiretroviral therapy and pregnancy outcome. Results: Among women enrolled, the proportion with heterosexual acquisition of infection has increased significantly from 59% (201/342) in 1985-1987 to 69% (327/471) after 1997 while the proportion acquiring HIV through injecting drug use has declined. Overall median CD4 cell count was 440 × 106/l and 41% of women had undetectable viral load at delivery. In 1995 28% (72/256) of mother-child pairs received the full 076 regimen to reduce risk of vertical transmission, rising significantly to 89% (116/130) by 1999. Use of triple therapy started in pregnancy has increased significantly from < 1% (1/153) in 1997 to 44% (47/107) in 1999. Exposure to antiretroviral therapy was not associated with prevalence or pattern of congenital abnormalities (P = 0.88) but was associated with reversible anaemia in the infant (P < 0.002). The elective cesarean section rate has increased from 10% in 1992 to 71% in 1999/2000. The vertical transmission rate declined from 15.5% by 1994 to 2.6% after 1998. In multivariate analysis, adjusting for maternal CD4 cell count, risk of vertical transmission was reduced by 66% (95% confidence interval, 37-82%) with the full 076 regimen and by 60% (95% confidence interval, 33-73%) with elective cesarean section delivery. Conclusions: Changes in treatment of adult HIV disease have affected the management of infected pregnant women. Despite therapeutic and surgical interventions, vertical transmission still occurs. {\textcopyright} 2001 Lippincott Williams & Wilkins.",

keywords = "AIDS, Antiretroviral therapy, Epidemiology, Pregnancy, Vertical transmission",

author = "C. Giaquinto and E. Ruga and {De Rossi}, A. and I. Grosch-W{\"o}rner and K. Seel and J. Mok and F. Johnstone and Garcia-Rodriguez, {M. C.} and I. Bates and {de Jos{\'e}}, I. and F. Hawkins and {Ladr{\'o}n de Gevara}, C. and {Ma Pe{\~n}a}, J. and {Gonzalez Garcia}, J. and {Arribas Lopez}, {J. R.} and F. Asensi-Botet and Otero, {M. C.} and D. P{\'e}rez-Tamarit and S. Ridaura and P. Gregori and {de la Torre}, R. and H. Scherpbier and M. Kreyenbroek and K. Boer and Bohlin, {A. B.} and S. Lindgren and A. Ehrnst and B. Anz{\'e}n and K. Lidman and E. Belfrage and L. Nav{\'e}r and J. Levy and P. Barlow and M. Hainaut and A. Peltier and S. Wibaut and G. Debruyne and A. Ferrazin and D. Bassetti and {De Maria}, A. and C. Gotta and A. Mur and A. Pay{\`a} and M. Vi{\~n}olas and L{\'o}pez-Vilchez, {M. A.} and P. Martinez-G{\'o}mez and R. Carreras and J. Jimenez and O. Coll and C. Fortuny and J. Bogu{\~n}a and {Casellas Caro}, M. and Y. Canet and G. Pardi and M. Ravizza and B. Guerra and M. Lanari and L. Bovicelli and E. Prati and M. Duse and G. Scaravelli and M. Stegagno and {De Santis}, M. and Semprini, {A. E.} and V. Savasi and A. Vigan{\`o} and {Ravagni Probizer}, F. and A. Maccabruni and A. Bucceri and L. Rancilio and Taylor, {G. P.} and Lyall, {E. G.H.} and Z. Penn and Valerius, {N. H.} and W. Buffolano and P. Martinelli and M. Sansone and C. Tibaldi and N. Ziarati and C. Benedetto and T. Niemie{\c c} and A. Horban",

year = "2001",

month = apr,

day = "13",

doi = "10.1097/00002030-200104130-00012",

language = "English",

volume = "15",

pages = "761--770",

number = "6",

}

Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Wörner, I, Seel, K, Mok, J, Johnstone, F, Garcia-Rodriguez, MC, Bates, I, de José, I, Hawkins, F, Ladrón de Gevara, C, Ma Peña, J, Gonzalez Garcia, J, Arribas Lopez, JR, Asensi-Botet, F, Otero, MC, Pérez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Anzén, B, Lidman, K, Belfrage, E, Navér, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Debruyne, G, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A , Payà, A, Viñolas, M, López-Vilchez, MA, Martinez-Gómez, P, Carreras, R, Jimenez, J, Coll, O, Fortuny, C, Boguña, J, Casellas Caro, M, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, De Santis, M, Semprini, AE, Savasi, V, Viganò, A, Ravagni Probizer, F, Maccabruni, A, Bucceri, A, Rancilio, L, Taylor, GP, Lyall, EGH, Penn, Z, Valerius, NH, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Ziarati, N, Benedetto, C, Niemieç, T & Horban, A 2001, 'HIV-infected pregnant women and vertical transmission in Europe since 1986', AIDS, vol. 15, no. 6, pp. 761-770. https://doi.org/10.1097/00002030-200104130-00012

HIV-infected pregnant women and vertical transmission in Europe since 1986. / Giaquinto, C.; Ruga, E.; De Rossi, A.; Grosch-Wörner, I.; Seel, K.; Mok, J.; Johnstone, F.; Garcia-Rodriguez, M. C.; Bates, I.; de José, I.; Hawkins, F.; Ladrón de Gevara, C.; Ma Peña, J.; Gonzalez Garcia, J.; Arribas Lopez, J. R.; Asensi-Botet, F.; Otero, M. C.; Pérez-Tamarit, D.; Ridaura, S.; Gregori, P.; de la Torre, R.; Scherpbier, H.; Kreyenbroek, M.; Boer, K.; Bohlin, A. B.; Lindgren, S.; Ehrnst, A.; Anzén, B.; Lidman, K.; Belfrage, E.; Navér, L.; Levy, J.; Barlow, P.; Hainaut, M.; Peltier, A.; Wibaut, S.; Debruyne, G.; Ferrazin, A.; Bassetti, D.; De Maria, A.; Gotta, C.; Mur, A.; Payà, A.; Viñolas, M.; López-Vilchez, M. A.; Martinez-Gómez, P.; Carreras, R.; Jimenez, J.; Coll, O.; Fortuny, C.; Boguña, J.; Casellas Caro, M.; Canet, Y.; Pardi, G.; Ravizza, M.; Guerra, B.; Lanari, M.; Bovicelli, L.; Prati, E.; Duse, M.; Scaravelli, G.; Stegagno, M.; De Santis, M.; Semprini, A. E.; Savasi, V.; Viganò, A.; Ravagni Probizer, F.; Maccabruni, A.; Bucceri, A.; Rancilio, L.; Taylor, G. P.; Lyall, E. G.H.; Penn, Z.; Valerius, N. H.; Buffolano, W.; Martinelli, P.; Sansone, M.; Tibaldi, C.; Ziarati, N.; Benedetto, C.; Niemieç, T.; Horban, A.

In: AIDS, Vol. 15, No. 6, 13.04.2001, p. 761-770.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - HIV-infected pregnant women and vertical transmission in Europe since 1986

AU - Giaquinto, C.

AU - Ruga, E.

AU - De Rossi, A.

AU - Grosch-Wörner, I.

AU - Seel, K.

AU - Mok, J.

AU - Johnstone, F.

AU - Garcia-Rodriguez, M. C.

AU - Bates, I.

AU - de José, I.

AU - Hawkins, F.

AU - Ladrón de Gevara, C.

AU - Ma Peña, J.

AU - Gonzalez Garcia, J.

AU - Arribas Lopez, J. R.

AU - Asensi-Botet, F.

AU - Otero, M. C.

AU - Pérez-Tamarit, D.

AU - Ridaura, S.

AU - Gregori, P.

AU - de la Torre, R.

AU - Scherpbier, H.

AU - Kreyenbroek, M.

AU - Boer, K.

AU - Bohlin, A. B.

AU - Lindgren, S.

AU - Ehrnst, A.

AU - Anzén, B.

AU - Lidman, K.

AU - Belfrage, E.

AU - Navér, L.

AU - Levy, J.

AU - Barlow, P.

AU - Hainaut, M.

AU - Peltier, A.

AU - Wibaut, S.

AU - Debruyne, G.

AU - Ferrazin, A.

AU - Bassetti, D.

AU - De Maria, A.

AU - Gotta, C.

AU - Mur, A.

AU - Payà, A.

AU - Viñolas, M.

AU - López-Vilchez, M. A.

AU - Martinez-Gómez, P.

AU - Carreras, R.

AU - Jimenez, J.

AU - Coll, O.

AU - Fortuny, C.

AU - Boguña, J.

AU - Casellas Caro, M.

AU - Canet, Y.

AU - Pardi, G.

AU - Ravizza, M.

AU - Guerra, B.

AU - Lanari, M.

AU - Bovicelli, L.

AU - Prati, E.

AU - Duse, M.

AU - Scaravelli, G.

AU - Stegagno, M.

AU - De Santis, M.

AU - Semprini, A. E.

AU - Savasi, V.

AU - Viganò, A.

AU - Ravagni Probizer, F.

AU - Maccabruni, A.

AU - Bucceri, A.

AU - Rancilio, L.

AU - Taylor, G. P.

AU - Lyall, E. G.H.

AU - Penn, Z.

AU - Valerius, N. H.

AU - Buffolano, W.

AU - Martinelli, P.

AU - Sansone, M.

AU - Tibaldi, C.

AU - Ziarati, N.

AU - Benedetto, C.

AU - Niemieç, T.

AU - Horban, A.

PY - 2001/4/13

Y1 - 2001/4/13

N2 - Objective: To describe changes over a 15-year period in characteristics and management of HIV-infected pregnant women in Europe. Design: Prospective study. Methods: Analysis of prospective data on 2876 pregnant HIV-infected women and their 3076 infants. Factors examined included maternal socio-demographic, immunological and virological characteristics, antiretroviral therapy and pregnancy outcome. Results: Among women enrolled, the proportion with heterosexual acquisition of infection has increased significantly from 59% (201/342) in 1985-1987 to 69% (327/471) after 1997 while the proportion acquiring HIV through injecting drug use has declined. Overall median CD4 cell count was 440 × 106/l and 41% of women had undetectable viral load at delivery. In 1995 28% (72/256) of mother-child pairs received the full 076 regimen to reduce risk of vertical transmission, rising significantly to 89% (116/130) by 1999. Use of triple therapy started in pregnancy has increased significantly from < 1% (1/153) in 1997 to 44% (47/107) in 1999. Exposure to antiretroviral therapy was not associated with prevalence or pattern of congenital abnormalities (P = 0.88) but was associated with reversible anaemia in the infant (P < 0.002). The elective cesarean section rate has increased from 10% in 1992 to 71% in 1999/2000. The vertical transmission rate declined from 15.5% by 1994 to 2.6% after 1998. In multivariate analysis, adjusting for maternal CD4 cell count, risk of vertical transmission was reduced by 66% (95% confidence interval, 37-82%) with the full 076 regimen and by 60% (95% confidence interval, 33-73%) with elective cesarean section delivery. Conclusions: Changes in treatment of adult HIV disease have affected the management of infected pregnant women. Despite therapeutic and surgical interventions, vertical transmission still occurs. © 2001 Lippincott Williams & Wilkins.

AB - Objective: To describe changes over a 15-year period in characteristics and management of HIV-infected pregnant women in Europe. Design: Prospective study. Methods: Analysis of prospective data on 2876 pregnant HIV-infected women and their 3076 infants. Factors examined included maternal socio-demographic, immunological and virological characteristics, antiretroviral therapy and pregnancy outcome. Results: Among women enrolled, the proportion with heterosexual acquisition of infection has increased significantly from 59% (201/342) in 1985-1987 to 69% (327/471) after 1997 while the proportion acquiring HIV through injecting drug use has declined. Overall median CD4 cell count was 440 × 106/l and 41% of women had undetectable viral load at delivery. In 1995 28% (72/256) of mother-child pairs received the full 076 regimen to reduce risk of vertical transmission, rising significantly to 89% (116/130) by 1999. Use of triple therapy started in pregnancy has increased significantly from < 1% (1/153) in 1997 to 44% (47/107) in 1999. Exposure to antiretroviral therapy was not associated with prevalence or pattern of congenital abnormalities (P = 0.88) but was associated with reversible anaemia in the infant (P < 0.002). The elective cesarean section rate has increased from 10% in 1992 to 71% in 1999/2000. The vertical transmission rate declined from 15.5% by 1994 to 2.6% after 1998. In multivariate analysis, adjusting for maternal CD4 cell count, risk of vertical transmission was reduced by 66% (95% confidence interval, 37-82%) with the full 076 regimen and by 60% (95% confidence interval, 33-73%) with elective cesarean section delivery. Conclusions: Changes in treatment of adult HIV disease have affected the management of infected pregnant women. Despite therapeutic and surgical interventions, vertical transmission still occurs. © 2001 Lippincott Williams & Wilkins.

KW - AIDS

KW - Antiretroviral therapy

KW - Epidemiology

KW - Pregnancy

KW - Vertical transmission

U2 - 10.1097/00002030-200104130-00012

DO - 10.1097/00002030-200104130-00012

M3 - Article

VL - 15

SP - 761

EP - 770

IS - 6

ER -