HIV RNA viral load and CD4+ T-cell counts in HIV-infected pregnant women with and without treatment discontinuation in early pregnancy

Enrico Tamburrini, Marina Ravizza, Marco Floridia, Cecilia Tibaldi, Salvatore Alberico, Gianfranco Anzidei, Anna Maccabruni, Alessandra Meloni, Anna Degli Antoni, Fernanda Mori, Serena Dalzero, Valentino Conserva, Carmela Pinnetti, Enrico Ferrazzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In pregnant women taking antiretroviral treatment at conception treatment may be transiently stopped for safety concerns. Limited data are available on the consequences of such discontinuations. Methods: We used data from a national study to compare different treatment pathways during pregnancy. Overall, 321 women were evaluated and classified into three groups: women not on treatment at conception and who started treatment during pregnancy (starters; n=91); women on treatment at conception who temporarily discontinued treatment during first trimester (discontinues; n=114); and women on treatment at conception who maintained treatment (continuers; n=116). Results: At conception, the three groups had similar CD4+ T-cell counts (499, 495 and 470 cells/mm3, respectively; P>0.10); starters had significantly higher median HIV RNA levels at conception (5,690 copies/ml) compared with both continuers (58 copies/ml, P+ T-cell levels (376 and 392 cells/mm3, respectively), which were reversed at last trimester (52 copies/ml and 432 cells/mm 3, respectively). No significant differences were observed among the groups in HIV RNA and CD4+ T-cell counts at third trimester, preterm delivery, low birth weight or mode of delivery. The number of cases of HIV transmission and birth defects were too limited to allow comparisons. Conclusions: Early discontinuation of antiretroviral treatment in pregnancy produces transient virological and immunological effects without precluding the achievement of a good viral suppression at the end of pregnancy; no clinical consequences were observed.

Original languageEnglish
Pages (from-to)519-527
Number of pages9
JournalAntiviral Therapy
Volume13
Issue number4
Publication statusPublished - 2008

ASJC Scopus subject areas

  • Pharmacology

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