title: Pregnancy in HIV vertically infected adolescents and young women: a new generation of HIV-exposed infants.
abstract: BACKGROUND
  Vertically infected individuals are reaching childbearing age and the new generation of HIV-exposed infants is coming to pediatric care.
  
  
  METHODS
  Chart review of pregnancies among HIV vertically infected adolescents and young women.
  
  
  RESULTS
  Fifteen pregnancies were reviewed. Girls had HIV diagnosis at median age 10.1 years (range 1.3-20). They started sexual life at median age 15 years (range 13-19); median age at pregnancy was 16.9 years (range 14-21.5); 36.4% had presented an AIDS-defining clinical event; have been followed for median 8.5 years (range 2.9-15.8) and had used median two antiretroviral regimens (range 0-7). Fourteen (93.3%) received antiretroviral drugs during pregnancy; median CD4 cell count during pregnancy was 394 (range 117-651) cells/μl and median viral load was 4800 copies/ml (range 50-100 000); 54% had undetectable viral load near delivery. All patients delivered by elective c-section. Median birth weight was 2650 g (range 2085-3595), median length was 47.3 cm (range 42-51) and median gestational age 38 weeks (range 37-39). All newborn received zidovudine for 6 weeks of life and none was breastfed. Fourteen (93%) infants were considered HIV-uninfected; one was lost to follow-up.
  
  
  CONCLUSIONS
  This group of adolescents seems to have sexual behavior similar to that of HIV-uninfected. Since this is an experimented antiretroviral population, new drugs may be necessary for adequate viral suppression to avoid HIV mother-to-child transmission. Follow-up of this third generation of HIV-exposed infants needs to be addressed within HIV adolescent care.
authors.affiliation: Hospital dos Servidores do Estado, Rio de Janeiro, Brazil. mleticia@diphse.com.br
authors.forename: Maria L S
authors.initials: ML
authors.lastname: Cruz
authors.forename: Claudete A
authors.initials: CA
authors.lastname: Cardoso
authors.forename: Esau C
authors.initials: EC
authors.lastname: João
authors.forename: Ivete M
authors.initials: IM
authors.lastname: Gomes
authors.forename: Thalita F
authors.initials: TF
authors.lastname: Abreu
authors.forename: Ricardo H
authors.initials: RH
authors.lastname: Oliveira
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Machado
authors.forename: Ilda R
authors.initials: IR
authors.lastname: Dias
authors.forename: Norma M
authors.initials: NM
authors.lastname: Rubini
authors.forename: Regina M
authors.initials: RM
authors.lastname: Succi
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D019562:Viral Load; D055815:Young Adult