The second generation of HIV-1 vertically exposed infants: A case series from the Italian Register for paediatric HIV infection

Carmelina Calitri, Clara Gabiano, Luisa Galli, Elena Chiappini, Carlo Giaquinto, Wilma Buffolano, Orazio Genovese, Susanna Esposito, Stefania Bernardi, Maurizio De Martino, Pier Angelo Tovo, Patrizia Osimani, Domenico Larovere, Maurizio Ruggeri, Andrea Pession, Giacomo Faldella, Francesca Capra, Sara Pulcini, Valentina Zattoni, Maurizio DedoniAntonia Aliffi, Elisa Anastasio, Elisa Fiumana, Paola Gervaso, Carlotta Montagnani, Antonio Di Biagio, Laura Ambra Nicolini, Laura De Hoffer, Maria Sole Acutis, Elisabetta Bondi, Paola Erba, Valentina Fabiano, Giulia Ramponi, Filippo Salvini, Rita Lipreri, Anna Plebani, Claudia Tagliabue, Francesca Giubbarelli, Emanuele Nicastro, Andrea Lo Vecchio, Maura Agnese, Amelia Romano, Osvalda Rampon, Martina Pennazzato, Rita Consolini, Icilio Dodi, Anna Maccabruni, Paolo Palma, Giuseppe Pontrelli, Hyppolite Tchidjou, Paolina Olmeo, Antonio Mazza, Erika Silvestro, Silvia Virano, Vincenzo Portelli, Marco Rabusin, Antonio Pellegatta

Research output: Contribution to journalArticle

Abstract

Background: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.Methods: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.Results: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 - 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection.Conclusions: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

Original languageEnglish
Article number277
JournalBMC Infectious Diseases
Volume14
Issue number1
DOIs
Publication statusPublished - May 20 2014

Keywords

  • AZT
  • Drug-resistant virus
  • HIV-1
  • Vertical transmission

ASJC Scopus subject areas

  • Infectious Diseases
  • Medicine(all)

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    Calitri, C., Gabiano, C., Galli, L., Chiappini, E., Giaquinto, C., Buffolano, W., Genovese, O., Esposito, S., Bernardi, S., De Martino, M., Tovo, P. A., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., ... Pellegatta, A. (2014). The second generation of HIV-1 vertically exposed infants: A case series from the Italian Register for paediatric HIV infection. BMC Infectious Diseases, 14(1), [277]. https://doi.org/10.1186/1471-2334-14-277