Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy

M. de Martino, L. Galli, P. A. Tovo, C. Gabiano, M. Zappa, P. Osimani, P. Zizzadoro, D. de Mattia, M. Ruggeri, M. Lanari, S. Dalla Vecchia, M. Masi, A. Miniaci, F. Baldi, G. Dell'Erba, L. Battisti, M. Duse, P. Crispino, E. Uberti, E. BrescianiP. G. Chiriacò, C. Pintor, M. Dedoni, D. Loriano, C. Dessì, L. Anastasio, G. Sabatino, M. Sticca, R. Berrino, A. Lodato, A. Vierucci, S. Farina, M. de Luca, A. de Maria, F. Fioredda, S. Boni, M. G. Marazzi, E. Pontali, G. L. Forni, G. L. Forni, C. Gotta, L. Tasso, G. Gambaretto, A. Meo, A. Plebani, R. Pinzani, F. Salvini, P. Marchisio, E. Massironi, R. Tornaghi, G. V. Zuccotti, S. Riva, S. de Carlis, G. Ferraris, A. Bucceri, R. Lipreri, M. Cellini, A. Guarino, C. Pignata, L. Tarallo, C. Giaquinto, E. Ruga, O. Rampon, A. Romano, G. Benaglia, D. Caselli, A. Maccabruni, R. Consolini, G. Palla, A. Antonellini, C. Magnani, T. Cecchi, G. Castelli Gattinara, S. Bernardi, C. Cancrini, C. Fundarò, O. Genovese, C. Rendeli, C. Timpano, G. Anzidei, S. Catania, M. Stegagno, A. Mazza, C. Salvatore, C. Scolfaro, E. Palomba, C. Riva, A. Pellegatta

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the outcome in children perinatally infected with HIV-1 whose mothers received zidovudine (ZDV) monotherapy in pregnancy. Design: Observational retrospective study of a prospectively recruited cohort. Setting: Italian Register for HIV Infection in Children. Patients: A group of 216 children perinatally infected with HIV-1, born in 1992-1997 and derived prospectively from birth: 38 children had mothers receiving ZDV monotherapy and for 178 children the mothers received no antiretroviral treatment during pregnancy. Main outcome measures: The estimated probability of developing severe disease or severe immune suppression, survival probability [95% confidence interval (CI)] within 3 years, and the hazard ratio (95% CI), adjusted for year of birth, maternal clinical condition at delivery, birthweight and treatments (Pneumocystis carinii pneumonia chemoprophylaxis and/or antiretroviral therapy before the onset of severe disease, severe immune suppression or death) were compared. Results: Comparison of HIV-1-infected children whose mothers were treated with ZDV with children whose mothers were not treated showed that the former group had a higher probability of developing severe disease [57.3% (95% CI 40.9-74.3) versus 37.2% (95% CI 30.0-45.4); log-rank test 7.83, P = 0.005; adjusted hazard ratio 1.8 (95% CI 1.1-3.1)] or severe immune suppression [53.9% (95% CI 36.3-73.5) versus 37.5% (95% CI 30.0-46.2); log-rank test 5.58, P = 0.018; adjusted hazard ratio 2.4, (95% CI: 1.3-4.3)] and a lower survival [72.2% (95% CI 50.4-85.7) versus 81.0% (95% CI 73.7-86.5); log-rank test 4.23, P = 0.039; adjusted hazard ratio of death 1.9 (95% CI 1.1-3.6)]. Conclusions: This epidemiological observation could stimulate virologic studies to elucidate whether this rapid progression depends on in utero infection or transmission of resistant virus. Findings may suggest a need to hasten HIV-1 diagnosis in infants of ZDV-treated mothers and undertake an aggressive antiretroviral therapy in those found to be infected.

Original languageEnglish
Pages (from-to)927-933
Number of pages7
JournalAIDS (London, England)
Volume13
Issue number8
DOIs
Publication statusPublished - 1999

Fingerprint

Zidovudine
Disease Progression
HIV-1
Mothers
Confidence Intervals
Pregnancy
Parturition
Pneumocystis Pneumonia
Infectious Disease Transmission
Survival
Immune System Diseases
Chemoprevention
Therapeutics
HIV Infections
Observational Studies
Retrospective Studies
Observation
Outcome Assessment (Health Care)
Viruses

Keywords

  • Disease progression
  • Perinatal infection
  • Zidovudine
  • Zidovudine in pregnancy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy. / de Martino, M.; Galli, L.; Tovo, P. A.; Gabiano, C.; Zappa, M.; Osimani, P.; Zizzadoro, P.; de Mattia, D.; Ruggeri, M.; Lanari, M.; Dalla Vecchia, S.; Masi, M.; Miniaci, A.; Baldi, F.; Dell'Erba, G.; Battisti, L.; Duse, M.; Crispino, P.; Uberti, E.; Bresciani, E.; Chiriacò, P. G.; Pintor, C.; Dedoni, M.; Loriano, D.; Dessì, C.; Anastasio, L.; Sabatino, G.; Sticca, M.; Berrino, R.; Lodato, A.; Vierucci, A.; Farina, S.; de Luca, M.; de Maria, A.; Fioredda, F.; Boni, S.; Marazzi, M. G.; Pontali, E.; Forni, G. L.; Forni, G. L.; Gotta, C.; Tasso, L.; Gambaretto, G.; Meo, A.; Plebani, A.; Pinzani, R.; Salvini, F.; Marchisio, P.; Massironi, E.; Tornaghi, R.; Zuccotti, G. V.; Riva, S.; de Carlis, S.; Ferraris, G.; Bucceri, A.; Lipreri, R.; Cellini, M.; Guarino, A.; Pignata, C.; Tarallo, L.; Giaquinto, C.; Ruga, E.; Rampon, O.; Romano, A.; Benaglia, G.; Caselli, D.; Maccabruni, A.; Consolini, R.; Palla, G.; Antonellini, A.; Magnani, C.; Cecchi, T.; Castelli Gattinara, G.; Bernardi, S.; Cancrini, C.; Fundarò, C.; Genovese, O.; Rendeli, C.; Timpano, C.; Anzidei, G.; Catania, S.; Stegagno, M.; Mazza, A.; Salvatore, C.; Scolfaro, C.; Palomba, E.; Riva, C.; Pellegatta, A.

In: AIDS (London, England), Vol. 13, No. 8, 1999, p. 927-933.

Research output: Contribution to journalArticle

de Martino, M, Galli, L, Tovo, PA, Gabiano, C, Zappa, M, Osimani, P, Zizzadoro, P, de Mattia, D, Ruggeri, M, Lanari, M, Dalla Vecchia, S, Masi, M, Miniaci, A, Baldi, F, Dell'Erba, G, Battisti, L, Duse, M, Crispino, P, Uberti, E, Bresciani, E, Chiriacò, PG, Pintor, C, Dedoni, M, Loriano, D, Dessì, C, Anastasio, L, Sabatino, G, Sticca, M, Berrino, R, Lodato, A, Vierucci, A, Farina, S, de Luca, M, de Maria, A, Fioredda, F, Boni, S, Marazzi, MG, Pontali, E, Forni, GL, Forni, GL, Gotta, C, Tasso, L, Gambaretto, G, Meo, A, Plebani, A, Pinzani, R, Salvini, F, Marchisio, P, Massironi, E, Tornaghi, R, Zuccotti, GV, Riva, S, de Carlis, S, Ferraris, G, Bucceri, A, Lipreri, R, Cellini, M, Guarino, A, Pignata, C, Tarallo, L, Giaquinto, C, Ruga, E, Rampon, O, Romano, A, Benaglia, G, Caselli, D, Maccabruni, A, Consolini, R, Palla, G, Antonellini, A, Magnani, C, Cecchi, T, Castelli Gattinara, G, Bernardi, S, Cancrini, C, Fundarò, C, Genovese, O, Rendeli, C, Timpano, C, Anzidei, G, Catania, S, Stegagno, M, Mazza, A, Salvatore, C, Scolfaro, C, Palomba, E, Riva, C & Pellegatta, A 1999, 'Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy', AIDS (London, England), vol. 13, no. 8, pp. 927-933. https://doi.org/10.1097/00002030-199905280-00008
de Martino, M. ; Galli, L. ; Tovo, P. A. ; Gabiano, C. ; Zappa, M. ; Osimani, P. ; Zizzadoro, P. ; de Mattia, D. ; Ruggeri, M. ; Lanari, M. ; Dalla Vecchia, S. ; Masi, M. ; Miniaci, A. ; Baldi, F. ; Dell'Erba, G. ; Battisti, L. ; Duse, M. ; Crispino, P. ; Uberti, E. ; Bresciani, E. ; Chiriacò, P. G. ; Pintor, C. ; Dedoni, M. ; Loriano, D. ; Dessì, C. ; Anastasio, L. ; Sabatino, G. ; Sticca, M. ; Berrino, R. ; Lodato, A. ; Vierucci, A. ; Farina, S. ; de Luca, M. ; de Maria, A. ; Fioredda, F. ; Boni, S. ; Marazzi, M. G. ; Pontali, E. ; Forni, G. L. ; Forni, G. L. ; Gotta, C. ; Tasso, L. ; Gambaretto, G. ; Meo, A. ; Plebani, A. ; Pinzani, R. ; Salvini, F. ; Marchisio, P. ; Massironi, E. ; Tornaghi, R. ; Zuccotti, G. V. ; Riva, S. ; de Carlis, S. ; Ferraris, G. ; Bucceri, A. ; Lipreri, R. ; Cellini, M. ; Guarino, A. ; Pignata, C. ; Tarallo, L. ; Giaquinto, C. ; Ruga, E. ; Rampon, O. ; Romano, A. ; Benaglia, G. ; Caselli, D. ; Maccabruni, A. ; Consolini, R. ; Palla, G. ; Antonellini, A. ; Magnani, C. ; Cecchi, T. ; Castelli Gattinara, G. ; Bernardi, S. ; Cancrini, C. ; Fundarò, C. ; Genovese, O. ; Rendeli, C. ; Timpano, C. ; Anzidei, G. ; Catania, S. ; Stegagno, M. ; Mazza, A. ; Salvatore, C. ; Scolfaro, C. ; Palomba, E. ; Riva, C. ; Pellegatta, A. / Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy. In: AIDS (London, England). 1999 ; Vol. 13, No. 8. pp. 927-933.
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title = "Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy",
abstract = "Objective: To investigate the outcome in children perinatally infected with HIV-1 whose mothers received zidovudine (ZDV) monotherapy in pregnancy. Design: Observational retrospective study of a prospectively recruited cohort. Setting: Italian Register for HIV Infection in Children. Patients: A group of 216 children perinatally infected with HIV-1, born in 1992-1997 and derived prospectively from birth: 38 children had mothers receiving ZDV monotherapy and for 178 children the mothers received no antiretroviral treatment during pregnancy. Main outcome measures: The estimated probability of developing severe disease or severe immune suppression, survival probability [95{\%} confidence interval (CI)] within 3 years, and the hazard ratio (95{\%} CI), adjusted for year of birth, maternal clinical condition at delivery, birthweight and treatments (Pneumocystis carinii pneumonia chemoprophylaxis and/or antiretroviral therapy before the onset of severe disease, severe immune suppression or death) were compared. Results: Comparison of HIV-1-infected children whose mothers were treated with ZDV with children whose mothers were not treated showed that the former group had a higher probability of developing severe disease [57.3{\%} (95{\%} CI 40.9-74.3) versus 37.2{\%} (95{\%} CI 30.0-45.4); log-rank test 7.83, P = 0.005; adjusted hazard ratio 1.8 (95{\%} CI 1.1-3.1)] or severe immune suppression [53.9{\%} (95{\%} CI 36.3-73.5) versus 37.5{\%} (95{\%} CI 30.0-46.2); log-rank test 5.58, P = 0.018; adjusted hazard ratio 2.4, (95{\%} CI: 1.3-4.3)] and a lower survival [72.2{\%} (95{\%} CI 50.4-85.7) versus 81.0{\%} (95{\%} CI 73.7-86.5); log-rank test 4.23, P = 0.039; adjusted hazard ratio of death 1.9 (95{\%} CI 1.1-3.6)]. Conclusions: This epidemiological observation could stimulate virologic studies to elucidate whether this rapid progression depends on in utero infection or transmission of resistant virus. Findings may suggest a need to hasten HIV-1 diagnosis in infants of ZDV-treated mothers and undertake an aggressive antiretroviral therapy in those found to be infected.",
keywords = "Disease progression, Perinatal infection, Zidovudine, Zidovudine in pregnancy",
author = "{de Martino}, M. and L. Galli and Tovo, {P. A.} and C. Gabiano and M. Zappa and P. Osimani and P. Zizzadoro and {de Mattia}, D. and M. Ruggeri and M. Lanari and {Dalla Vecchia}, S. and M. Masi and A. Miniaci and F. Baldi and G. Dell'Erba and L. Battisti and M. Duse and P. Crispino and E. Uberti and E. Bresciani and Chiriac{\`o}, {P. G.} and C. Pintor and M. Dedoni and D. Loriano and C. Dess{\`i} and L. Anastasio and G. Sabatino and M. Sticca and R. Berrino and A. Lodato and A. Vierucci and S. Farina and {de Luca}, M. and {de Maria}, A. and F. Fioredda and S. Boni and Marazzi, {M. G.} and E. Pontali and Forni, {G. L.} and Forni, {G. L.} and C. Gotta and L. Tasso and G. Gambaretto and A. Meo and A. Plebani and R. Pinzani and F. Salvini and P. Marchisio and E. Massironi and R. Tornaghi and Zuccotti, {G. V.} and S. Riva and {de Carlis}, S. and G. Ferraris and A. Bucceri and R. Lipreri and M. Cellini and A. Guarino and C. Pignata and L. Tarallo and C. Giaquinto and E. Ruga and O. Rampon and A. Romano and G. Benaglia and D. Caselli and A. Maccabruni and R. Consolini and G. Palla and A. Antonellini and C. Magnani and T. Cecchi and {Castelli Gattinara}, G. and S. Bernardi and C. Cancrini and C. Fundar{\`o} and O. Genovese and C. Rendeli and C. Timpano and G. Anzidei and S. Catania and M. Stegagno and A. Mazza and C. Salvatore and C. Scolfaro and E. Palomba and C. Riva and A. Pellegatta",
year = "1999",
doi = "10.1097/00002030-199905280-00008",
language = "English",
volume = "13",
pages = "927--933",
journal = "AIDS",
issn = "0269-9370",
publisher = "NLM (Medline)",
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TY - JOUR

T1 - Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy

AU - de Martino, M.

AU - Galli, L.

AU - Tovo, P. A.

AU - Gabiano, C.

AU - Zappa, M.

AU - Osimani, P.

AU - Zizzadoro, P.

AU - de Mattia, D.

AU - Ruggeri, M.

AU - Lanari, M.

AU - Dalla Vecchia, S.

AU - Masi, M.

AU - Miniaci, A.

AU - Baldi, F.

AU - Dell'Erba, G.

AU - Battisti, L.

AU - Duse, M.

AU - Crispino, P.

AU - Uberti, E.

AU - Bresciani, E.

AU - Chiriacò, P. G.

AU - Pintor, C.

AU - Dedoni, M.

AU - Loriano, D.

AU - Dessì, C.

AU - Anastasio, L.

AU - Sabatino, G.

AU - Sticca, M.

AU - Berrino, R.

AU - Lodato, A.

AU - Vierucci, A.

AU - Farina, S.

AU - de Luca, M.

AU - de Maria, A.

AU - Fioredda, F.

AU - Boni, S.

AU - Marazzi, M. G.

AU - Pontali, E.

AU - Forni, G. L.

AU - Forni, G. L.

AU - Gotta, C.

AU - Tasso, L.

AU - Gambaretto, G.

AU - Meo, A.

AU - Plebani, A.

AU - Pinzani, R.

AU - Salvini, F.

AU - Marchisio, P.

AU - Massironi, E.

AU - Tornaghi, R.

AU - Zuccotti, G. V.

AU - Riva, S.

AU - de Carlis, S.

AU - Ferraris, G.

AU - Bucceri, A.

AU - Lipreri, R.

AU - Cellini, M.

AU - Guarino, A.

AU - Pignata, C.

AU - Tarallo, L.

AU - Giaquinto, C.

AU - Ruga, E.

AU - Rampon, O.

AU - Romano, A.

AU - Benaglia, G.

AU - Caselli, D.

AU - Maccabruni, A.

AU - Consolini, R.

AU - Palla, G.

AU - Antonellini, A.

AU - Magnani, C.

AU - Cecchi, T.

AU - Castelli Gattinara, G.

AU - Bernardi, S.

AU - Cancrini, C.

AU - Fundarò, C.

AU - Genovese, O.

AU - Rendeli, C.

AU - Timpano, C.

AU - Anzidei, G.

AU - Catania, S.

AU - Stegagno, M.

AU - Mazza, A.

AU - Salvatore, C.

AU - Scolfaro, C.

AU - Palomba, E.

AU - Riva, C.

AU - Pellegatta, A.

PY - 1999

Y1 - 1999

N2 - Objective: To investigate the outcome in children perinatally infected with HIV-1 whose mothers received zidovudine (ZDV) monotherapy in pregnancy. Design: Observational retrospective study of a prospectively recruited cohort. Setting: Italian Register for HIV Infection in Children. Patients: A group of 216 children perinatally infected with HIV-1, born in 1992-1997 and derived prospectively from birth: 38 children had mothers receiving ZDV monotherapy and for 178 children the mothers received no antiretroviral treatment during pregnancy. Main outcome measures: The estimated probability of developing severe disease or severe immune suppression, survival probability [95% confidence interval (CI)] within 3 years, and the hazard ratio (95% CI), adjusted for year of birth, maternal clinical condition at delivery, birthweight and treatments (Pneumocystis carinii pneumonia chemoprophylaxis and/or antiretroviral therapy before the onset of severe disease, severe immune suppression or death) were compared. Results: Comparison of HIV-1-infected children whose mothers were treated with ZDV with children whose mothers were not treated showed that the former group had a higher probability of developing severe disease [57.3% (95% CI 40.9-74.3) versus 37.2% (95% CI 30.0-45.4); log-rank test 7.83, P = 0.005; adjusted hazard ratio 1.8 (95% CI 1.1-3.1)] or severe immune suppression [53.9% (95% CI 36.3-73.5) versus 37.5% (95% CI 30.0-46.2); log-rank test 5.58, P = 0.018; adjusted hazard ratio 2.4, (95% CI: 1.3-4.3)] and a lower survival [72.2% (95% CI 50.4-85.7) versus 81.0% (95% CI 73.7-86.5); log-rank test 4.23, P = 0.039; adjusted hazard ratio of death 1.9 (95% CI 1.1-3.6)]. Conclusions: This epidemiological observation could stimulate virologic studies to elucidate whether this rapid progression depends on in utero infection or transmission of resistant virus. Findings may suggest a need to hasten HIV-1 diagnosis in infants of ZDV-treated mothers and undertake an aggressive antiretroviral therapy in those found to be infected.

AB - Objective: To investigate the outcome in children perinatally infected with HIV-1 whose mothers received zidovudine (ZDV) monotherapy in pregnancy. Design: Observational retrospective study of a prospectively recruited cohort. Setting: Italian Register for HIV Infection in Children. Patients: A group of 216 children perinatally infected with HIV-1, born in 1992-1997 and derived prospectively from birth: 38 children had mothers receiving ZDV monotherapy and for 178 children the mothers received no antiretroviral treatment during pregnancy. Main outcome measures: The estimated probability of developing severe disease or severe immune suppression, survival probability [95% confidence interval (CI)] within 3 years, and the hazard ratio (95% CI), adjusted for year of birth, maternal clinical condition at delivery, birthweight and treatments (Pneumocystis carinii pneumonia chemoprophylaxis and/or antiretroviral therapy before the onset of severe disease, severe immune suppression or death) were compared. Results: Comparison of HIV-1-infected children whose mothers were treated with ZDV with children whose mothers were not treated showed that the former group had a higher probability of developing severe disease [57.3% (95% CI 40.9-74.3) versus 37.2% (95% CI 30.0-45.4); log-rank test 7.83, P = 0.005; adjusted hazard ratio 1.8 (95% CI 1.1-3.1)] or severe immune suppression [53.9% (95% CI 36.3-73.5) versus 37.5% (95% CI 30.0-46.2); log-rank test 5.58, P = 0.018; adjusted hazard ratio 2.4, (95% CI: 1.3-4.3)] and a lower survival [72.2% (95% CI 50.4-85.7) versus 81.0% (95% CI 73.7-86.5); log-rank test 4.23, P = 0.039; adjusted hazard ratio of death 1.9 (95% CI 1.1-3.6)]. Conclusions: This epidemiological observation could stimulate virologic studies to elucidate whether this rapid progression depends on in utero infection or transmission of resistant virus. Findings may suggest a need to hasten HIV-1 diagnosis in infants of ZDV-treated mothers and undertake an aggressive antiretroviral therapy in those found to be infected.

KW - Disease progression

KW - Perinatal infection

KW - Zidovudine

KW - Zidovudine in pregnancy

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UR - http://www.scopus.com/inward/citedby.url?scp=0033043731&partnerID=8YFLogxK

U2 - 10.1097/00002030-199905280-00008

DO - 10.1097/00002030-199905280-00008

M3 - Article

C2 - 10371173

AN - SCOPUS:0033043731

VL - 13

SP - 927

EP - 933

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 8

ER -