title: The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection.
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.
authors.forename: Carmelina
authors.initials: C
authors.lastname: Calitri
authors.forename: Clara
authors.initials: C
authors.lastname: Gabiano
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.forename: Wilma
authors.initials: W
authors.lastname: Buffolano
authors.forename: Orazio
authors.initials: O
authors.lastname: Genovese
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Stefania
authors.initials: S
authors.lastname: Bernardi
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Martino
authors.affiliation: Department of Paediatrics, University of Turin, Turin, Italy. pierangelo.tovo@unito.it.
authors.forename: Pier-Angelo
authors.initials: PA
authors.lastname: Tovo
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001724:Birth Weight; D002585:Cesarean Section; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D007558:Italy; D008297:Male; D010372:Pediatrics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D019562:Viral Load; D055815:Young Adult; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine