title: Antiretroviral Resistance and Pregnancy Characteristics of Women with Perinatal and Nonperinatal HIV Infection.
abstract: Objective. To compare HIV drug resistance in pregnant women with perinatal HIV (PHIV) and those with nonperinatal HIV (NPHIV) infection. Methods. We conducted a multisite cohort study of PHIV and NPHIV women from 2000 to 2014. Sample size was calculated to identify a fourfold increase in antiretroviral (ARV) drug resistance in PHIV women. Continuous variables were compared using Student's t-test and Wilcoxon rank-sum tests. Categorical variables were compared using χ (2) and Fisher's exact tests. Univariate analysis was used to determine factors associated with antiretroviral drug resistance. Results. Forty-one PHIV and 41 NPHIV participants were included. Women with PHIV were more likely to have drug resistance than those with NPHIV ((55% versus 17%, p = 0.03), OR 6.0 (95% CI 1.0-34.8), p = 0.05), including multiclass resistance (15% versus 0, p = 0.03), and they were more likely to receive nonstandard ARVs during pregnancy (27% versus 5%, p = 0.01). PHIV and NPHIV women had similar rates of preterm birth (11% versus 28%, p = 0.08) and cesarean delivery (47% versus 46%, p = 0.9). Two infants born to a single NPHIV woman acquired HIV infection. Conclusions. PHIV women have a high frequency of HIV drug resistance mutations, leading to nonstandard ARVs use during pregnancy. Despite nonstandard ARV use during pregnancy, PHIV women did not experience increased rates of adverse pregnancy outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 624, Charleston, SC 29425, USA.
authors.forename: Gweneth B
authors.identifier: 0000-0002-5233-442X
authors.initials: GB
authors.lastname: Lazenby
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, L4100 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
authors.forename: Okeoma
authors.initials: O
authors.lastname: Mmeje
authors.affiliation: Department of Pediatrics, University of Colorado Anschutz Medical Campus, 12700 E. 19th Box B168, Aurora, CO 80045, USA.
authors.forename: Barbra M
authors.initials: BM
authors.lastname: Fisher
authors.affiliation: Department of Pediatrics, University of Colorado Anschutz Medical Campus, 12700 E. 19th Box B168, Aurora, CO 80045, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Weinberg
authors.affiliation: Department of Medicine, Drexel University, 1427 Vine Street, 2nd Floor, Philadelphia, PA 19102, USA.
authors.forename: Erika K
authors.initials: EK
authors.lastname: Aaron
authors.affiliation: Department of Medicine, Drexel University, 1427 Vine Street, 2nd Floor, Philadelphia, PA 19102, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Keating
authors.affiliation: Department of Medicine, University of Rochester, 601 Elmwood Avenue, Box 689, Rochester, NY 14642, USA.
authors.forename: Amneris E
authors.initials: AE
authors.lastname: Luque
authors.affiliation: Department of Obstetrics and Gynecology, Washington University, 4921 Parkview Place, St. Louis, MO 63110, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Willers
authors.affiliation: Department of Obstetrics and Gynecology, University of California, 350 Parnassus Avenue No. 908, San Francisco, CA 94117, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Cohan
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, 1190 Hornby Street, 4th Floor, Vancouver, BC, Canada V6Z 2K5.
authors.forename: Deborah
authors.initials: D
authors.lastname: Money
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology
chemical_list: D019380:Anti-HIV Agents