Effect of Highly Active Antiretroviral Treatment (HAART) during Pregnancy on Pregnancy Outcomes: Experiences from a PMTCT Program in Western India

Shrinivas Darak, University of Groningen and Prayas Health Group
Trupti Darak, Prayas Health Group
Sanjeevani Kulkarni, Prayas Health Group
Vinay Kulkarni, Prayas Health Group
Ritu Parchure, Prayas Health Group
Fanny Janssen, University of Groningen

This study compared adverse pregnancy outcomes among HIV infected women (N=516) who received either HAART (N=192) or antepartum azidothymidine (AZT) with intrapartum nevirapine (N=324) from January 2008 to March 2012 through a PMTCT program in western India. We analysed the effect of HAART on preterm births, low birth weight and all adverse pregnancy outcomes combined using univariate and multivariate logistic regression models. Women on HAART had 48% adverse pregnancy outcomes, 25% preterm births, and 34% low birth weight children compared to respectively 32%, 13%, and 22% women on AZT. Women receiving HAART were more likely to have adverse pregnancy outcomes and preterm births compared to AZT. Preconception HAART was significantly related to low birth weight children. This study demonstrated increased risk of adverse pregnancy outcomes with protease inhibitor excluded HAART. Prospective studies assessing the impact of HAART on MTCT as measured in terms of HIV-free survival among children are needed.

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Presented in Poster Session 6