PMID- 32408754
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20210701
IS  - 1931-8405 (Electronic)
IS  - 0889-2229 (Linking)
VI  - 36
IP  - 8
DP  - 2020 Aug
TI  - Treatment Experience and Repeat Pregnancy Impact the Effectiveness of 
      Non-Nucleoside Reverse Transcription Inhibitor-Highly Active Antiretroviral 
      Therapy for the Prevention of Mother to Child Transmission of Human 
      Immunodeficiency Virus.
PG  - 681-687
LID - 10.1089/AID.2019.0001 [doi]
AB  - Non-nucleoside reverse transcription inhibitor (NNRTI)-containing antiretroviral 
      therapy (ART) for the prevention of mother to child transmission (PMTCT) of human 
      immunodeficiency virus (HIV) has led to dramatic reductions in perinatal HIV 
      infection in resource-constrained settings. Nonetheless, PMTCT programs are 
      complicated by repeat pregnancies, in which long-term or repeat exposures to 
      PMTCT regimens over time may lead to the acquisition of HIV drug resistance 
      mutations, and consequent treatment failure. In this study, we retrospectively 
      assessed the effectiveness of the NNRTI-based PMTCT protocol from 2008 to 2010 in 
      The Bahamas National HIV/AIDS Program. We show that women who had been in repeat 
      pregnancies and those who were already prescribed ART at conception were at 
      increased risk of virologic failure, relative to treatment-inexperienced women 
      and primigravida, respectively (AOR 3.1, 95% CI: 1.3-7.1, p = .008 and AOR 5.0, 
      95% CI: 1.8-14.1, p = .002). In addition, women undergoing treatment at 
      conception were more likely to possess HIVDR mutations relative to 
      treatment-naive women (AOR 447.1, 95% CI: 17.9-11,173.5, p = .001). Therefore, 
      individual treatment history is a key metric determining the effectiveness of 
      current and future PMTCT interventions. The implications of this to PMTCT 
      programmatic success in light of the most recent WHO guidelines are discussed.
FAU - Martin, Indira B
AU  - Martin IB
AD  - Reference Lab, The Bahamas Ministry of Health, Nassau, Bahamas.
FAU - Read, Stanley
AU  - Read S
AD  - Department of Paediatrics, University of Toronto Hospital for Sick Kids, Toronto, 
      Canada.
FAU - Harrigan, Richard
AU  - Harrigan R
AD  - Research Laboratory, British Columbia Centre for Excellence in HIV/AIDS, 
      Vancouver, Canada.
FAU - Gomez, M Perry
AU  - Gomez MP
AD  - Reference Lab, The Bahamas Ministry of Health, Nassau, Bahamas.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200609
PL  - United States
TA  - AIDS Res Hum Retroviruses
JT  - AIDS research and human retroviruses
JID - 8709376
RN  - 0 (Reverse Transcriptase Inhibitors)
SB  - IM
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Cross-Sectional Studies
MH  - Female
MH  - HIV Infections/*drug therapy/*prevention & control/transmission
MH  - Humans
MH  - Infectious Disease Transmission, Vertical/*prevention & control
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/drug therapy/virology
MH  - Retrospective Studies
MH  - Reverse Transcriptase Inhibitors/*adverse effects/classification/therapeutic use
MH  - Risk Factors
MH  - Viral Load
OTO - NOTNLM
OT  - HIV drug resistance
OT  - NNRTI
OT  - PMTCT
OT  - option B
EDAT- 2020/05/16 06:00
MHDA- 2021/07/02 06:00
CRDT- 2020/05/16 06:00
PHST- 2020/05/16 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2020/05/16 06:00 [entrez]
AID - 10.1089/AID.2019.0001 [doi]
PST - ppublish
SO  - AIDS Res Hum Retroviruses. 2020 Aug;36(8):681-687. doi: 10.1089/AID.2019.0001. 
      Epub 2020 Jun 9.