Pregnancy in HIV vertically infected adolescents and young women: a new generation of HIV-exposed infants

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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.

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