Русский
Use of a fixed-dose antiretroviral drug in HIV-infected pregnant women
DOI: https://dx.doi.org/10.18565/epidem.2022.12.2.87-94
Samarina A.V., Mozaleva O.L., Martirosyan M.M., Skryabneva T.S.
1) Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; 2) Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
Subjects and methods. This was a retrospective and prospective observational study of RPV/TDF/FTC (Eviplera) used in pregnant women. Forty-three patients whose pregnancy ended in childbirth in 2015 to 2021 were followed up.
Results. More than half of the pregnant women had an experience of HIV infection for more than 10 years; this pregnancy was consecutive in 86%, while primiparity was in more than two-thirds. The use of antiretroviral therapy (ART) lasted 9.4±0.9 (2–13) years; that of eviplera averaged 3.7 ± 0.7 years. During the RPV/TDF/FTC treatment, all the women had normal CD4+ lymphocyte counts (679.2±28.0 cells/µl) in the first trimester of pregnancy and 755.95 ± 38.6 cells/µl before delivery. In all the women, the level of HIV RNA was <40 copies/mL in the first trimester and at 34–36 weeks’ gestation. There were neither complaints associated with the intake of antiretroviral drugs, nor side effects or adverse events. A term delivery occurred in 9 out of 10 patients; the mean gestational age was 38.7±0.3 weeks at the time of delivery. In 80% of the women, their pregnancy ended in childbirth through the birth canal; indications for operative delivery were associated with obstetric pathology in all the cases. None of the newborns was found to have congenital malformations. There were no cases of perinatal HIV infection.
Conclusion. The prescription of RPV/TDF/FTC before pregnancy ensured stable suppression of viremia by the time of pregnancy diagnosis, no side effects or adverse events, as well as high adherence to treatment during pregnancy. The safety and efficacy of RPV/TDF/FTC were confirmed by the absence of congenital malformations in newborns and cases of perinatal infection.
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About the Autors
Anna V. Samarina, MD, Associate Professor, Professor, Department of Social Infections and Phthisiopulmology, Academician I.P. Pavlov Saint Petersburg State Medical University; Head, Department of Maternal and Infant Care, Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; avsamarina@mail.ru. https://doi.org/0000-0003-1438-2399; SPIN-код: 2878-7130
Olga L. Mozaleva, Obstetrician/Gynecologist, Department of Maternal and Infant Care, Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; mozaleva.o@yandex.ru; https://doi.org/0000-0003-4682-9394
Margarita M. Martirosian, Cand. Med. Sci., Obstetrician/Gynecologist, Department of Maternal and Infant Care, Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; martirosianmm@mail.ru
Tatiana S. Skryabneva, Obstetrician/Gynecologist, Department of Maternal and Infant Care, Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; skryabneva.tanya@mail.ru
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