Background: Abacavir-lamivudine (ABC/3TC) and tenofovir-emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study. Methods: Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC. Results: The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P < 0.001), and had lower CD4 counts (475/mm3 vs. 533/mm3, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein-cholesterol (133 vs. 111 mg/dL, P = 0.030). Conclusions: In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.

Abacavir/lamivudine and tenofovir/emtricitabine in pregnant women with HIV: Laboratory and clinical outcomes in an observational national study / M. Floridia, C. Pinnetti, M. Ravizza, G. Masuelli, C. Personeni, M. Sansone, A.D. Antoni, G. Guaraldi, A. Spinillo, B. Tassis, S. Dalzero, G. Liuzzi, E. Tamburrini, F. Di Lorenzo, G. Sterrantino, M. Meli, I. Campolmi, F. Vichi, B. Del Pin, R. Marocco, C. Mastroianni, V.S. Mercurio, A. Maccabruni, M. Zaramella, B. Mariani, G. Nardini, C. Stentarelli, B. Beghetto, A.M. Degli Antoni, A. Molinari, M.P. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, S. Coletto, F. Di Nello, C. Madia, G. Placido, P. Milini, F. Savalli, V. Portelli, F. Sabbatini, D. Francisci, C. Papalini, L. Bernini, P. Grossi, L. Rizzi, M. Bernardon, G. Maso, E. Rizzante, C. Belcaro, A. Meloni, M. Dedoni, F. Ortu, P. Piano, A. Citernesi, I.B. Vicini, K. Luzi, M. Roccio, A. Vimercati, A. Miccolis, A. De Gennaro, B. Guerra, F. Cervi, G. Simonazzi, E. Margarito, M.G. Capretti, C. Marsico, G. Faldella, P. Martinelli, A. Agangi, A. Capone, G.M. Maruotti, C. Tibaldi, L. Trentini, T. Todros, V. Frisina, I. Cetin, T. Brambilla, V. Savasi, C. Giaquinto, M. Fiscon, E. Rubino, L. Franceschetti, R. Badolato, G.C. Tiso, O. Genovese, C. Cafforio, A.M. Casadei, A.F. Cavaliere, M. Cellini, A.M. Marconi, V. Sacchi, M. Ierardi, C. Polizzi, A. Mattei, M.F. Pirillo, R. Amici, C.M. Galluzzo, S. Donnini, S. Baroncelli. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - 78:1(2018 May 01), pp. 99-104. [10.1097/QAI.0000000000001640]

Abacavir/lamivudine and tenofovir/emtricitabine in pregnant women with HIV: Laboratory and clinical outcomes in an observational national study

S. Dalzero
Membro del Collaboration Group
;
R. Marocco
Membro del Collaboration Group
;
G. Zuccotti
Membro del Collaboration Group
;
V. Giacomet
Membro del Collaboration Group
;
S. Coletto
Membro del Collaboration Group
;
F. Di Nello
Membro del Collaboration Group
;
C. Madia
Membro del Collaboration Group
;
F. Savalli
Membro del Collaboration Group
;
V. Portelli
Membro del Collaboration Group
;
M. Roccio
Membro del Collaboration Group
;
A. De Gennaro
Membro del Collaboration Group
;
C. Tibaldi
Membro del Collaboration Group
;
I. Cetin
Membro del Collaboration Group
;
V. Savasi
Membro del Collaboration Group
;
G.C. Tiso
Membro del Collaboration Group
;
C. Cafforio
Membro del Collaboration Group
;
A.M. Casadei
Membro del Collaboration Group
;
A.M. Marconi;M. Ierardi
Membro del Collaboration Group
;
2018-05-01

Abstract

Background: Abacavir-lamivudine (ABC/3TC) and tenofovir-emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study. Methods: Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC. Results: The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P < 0.001), and had lower CD4 counts (475/mm3 vs. 533/mm3, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein-cholesterol (133 vs. 111 mg/dL, P = 0.030). Conclusions: In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.
tenofovir; emtricitabine; lamivudine; abacavir; pregnancy; preterm delivery; low birthweight; HIV-RNA; cholesterol; anemiaAbacavir; Anemia; Cholesterol; Emtricitabine; HIV-RNA; Lamivudine; Low birthweight; Pregnancy; Preterm delivery; Tenofovir; AIDS-Associated Nephropathy; Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Cesarean Section; Cholesterol; Dideoxynucleosides; Drug Combinations; Emtricitabine; Female; HIV Infections; HIV-1; Hemoglobins; Humans; Hypertension; Lamivudine; Lipoproteins, LDL; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Third; RNA, Viral; Tenofovir
Settore MED/38 - Pediatria Generale e Specialistica
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/731637
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