Details

Autor(en) / Beteiligte

• Burgard, M.
• Jasseron, C.
• Matheron, S.
• Damond, F.
• Hamrene, K.
• Blanche, S.
• Faye, A.
• Rouzioux, C.
• Warszawski, J.
• Mandelbrot, L.

Titel

Mother-to-Child Transmission of HIV-2 Infection from 1986 to 2007 in the ANRS French Perinatal Cohort EPF-CO1

Ist Teil von

• Clinical infectious diseases, 2010-10, Vol.51 (7), p.833-843

Ort / Verlag

Oxford: The University of Chicago Press

Erscheinungsjahr

2010

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. Management of pregnant women with human immunodeficiency virus (HIV) type 2 infection remains unclear because of its low prevalence and important differences from HIV-1. Methods. Pregnant women monoinfected with HIV-2 or HIV-1 and their infants enrolled in the prospective, national, multicenter French Perinatal Cohort between 1986 and 2007. Results. Overall, 2.6% (223/8660) of mothers were infected with HIV-2, and they accounted for 3.1% (367/11841) of the total births. Most were born in sub-Saharan Africa. A higher proportion of HIV-2-infected mothers than HIV-1-infected mothers had no symptoms, had received no antiretroviral threrapy at conception (85.9% vs 66.7%), and had received no antiretroviral therapy during pregnancy (42.8% vs 19.9%), particularly highly active antiretroviral therapy (HAART) (79.7% vs 46.1%), and they had higher CD4 cell counts near delivery (median, 574 vs 452 cells/mm3; P < .01). If antiretroviral therapy was used, it was started at a later gestational age for HIV-2-infected mothers (median, 28 vs 25 weeks; P < .01). HIV-2-infected mothers were more likely to deliver vaginally (67.9% vs 49.3%) and to breastfeed (3.6% vs 0.6%; P < .01), and their infants less frequently received postexposure prophylaxis. In the period 2000–2007, the proportion with viral load <100 copies/mL at delivery was 90.5% of HIV-2-infected mothers, compared with 76.2% of HIV-1-infected mothers (P = .1). There were 2 cases of transmission: 1 case in 1993 occurred following maternal primary infection, and the other case occurred postnatally in 2002 and involved a mother with severe immune deficiency. The mother-to-child transmission rate for HIV-2 was 0.6% (95% confidence interval, 0.07%–2.2%). Conclusions. Care for HIV-2-infected pregnant women rests on expert opinion. The mother-to-child transmission residual rate (0.07%–2.2%) argues for systematic treatment: protease inhibitor-based HAART for women requiring antiretroviral therapy or for primary infection and simplified prevention of mother-to-child transmission in other instances.