Therapeutic and other interventions to reduce the risk of mother-to-child transmission of HIV-1 in Europe
Articolo
Data di Pubblicazione:
1998
Citazione:
Therapeutic and other interventions to reduce the risk of mother-to-child transmission of HIV-1 in Europe / M.L. Newell, S. Fiore, A.E. Semprini, V. Savasi. - In: BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. - ISSN 0306-5456. - 105:7(1998 Jul), pp. 704-709.
Abstract:
Objectives To document policies regarding the use of interventions to reduce risk of vertical transmission of human immunodeficiency virus (HIV) and assess the extent of changes since 1994.
Design A postal questionnaire survey and data from the European Collaborative Study (ECS), a prospective multi-centre cohort study.
Setting Fifty-four obstetric centres in 16 European countries.
Sample A questionnaire response from 54 obstetricians; 669 deliveries to HIV-infected women enrolled in the ECS from 1994 to 1997.
Main outcome measures Use of zidovudine during pregnancy, at delivery and to the neonate; caesarean section delivery rates; vaginal lavage; avoidance of breastfeeding; vertical transmission rate.
Results Zidovudine therapy to reduce vertical transmission is now widespread in Europe and routine in all but one centre surveyed, although regimens vary. In 11 (26%) centres elective caesarean section is offered to all HIV-infected women and a further nine (21%) have a policy of routine vaginal lavage. In all centres HIV-infected women are advised to avoid breastfeeding. In the ECS there has been a significant temporal decline in the vertical transmission rate with an increase in zidovudine use. More than 90% of women in the ECS who were delivered in 1997 received one or more components of zidovudine therapy; the rate of vertical transmission is 9% where zidovudine has been used, compared with 15% without use of zidovudine.
Conclusions Although the use of zidovudine to reduce vertical transmission is increasing in Europe and, with the avoidance of breastfeeding, is associated with a decline in vertical transmission, the success of these interventions will be limited by the uptake of antenatal screening.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Infectious Disease Transmission, Vertical ; Anti-HIV Agents ; Breast Feeding ; Humans ; Pregnancy Complications, Infectious ; Infant, Newborn ; Zidovudine ; Lamivudine ; Prenatal Care ; Europe ; Pregnancy ; Prospective Studies ; Didanosine ; HIV Infections ; Risk Factors ; Adult ; Cohort Studies ; Cesarean Section ; Female
Elenco autori:
M.L. Newell, S. Fiore, A.E. Semprini, V. Savasi
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