Journal of Antivirals & Antiretrovirals
Open Access

Abstract

Birth Outcomes in HIV-1-Infected Women Receiving Highly Active Antiretroviral Therapy (HAART) Prior to Conception versus During Pregnancy in Yaounde, Cameroon

Anne Esther Njom Nlend, Cecile Zeudja, Suzie Moyo, Annie Nga Motaze and The Therapeutic Committee of Centre Hospitalier d’ESSOS Djoungolo

Objective: To assess the impact of antiretroviral on birth outcome according to the timing of antiretroviral initiation in relation to pregnancy in human immunodeficiency virus (HIV) infected pregnant women. Methods: Cross sectional study, observational, in a single referral site, the Centre Hospitalier d’ESSOS of Yaoundé from 2008 to 2013. Babies born to HIV positive mothers under HAART prior to conception were compared with those initiating treatment during pregnancy. Main measurement: rate of preterm birth (PTB) defined as gestational age<37 weeks at birth and low birth weight (LBW)<2500 g. Results: We included 617 newborn babies. Almost 96% of their mothers were taking antiretroviral drugs free of protease inhibitor. Overall rate of LBW was at 11.6% and PTB at 9.7 %. In bivariate analysis, PTB were similarly rated in preconception HAART(8.1%) versus during pregnancy (10.1%), odd ratio (1.22: 0.6-2.5, p=0.90); in ART started during pregnancy, the PTB frequency was analogous, irrespective of the moment of antiretroviral therapy (ART) started before 28 weeks (10.9%), or after (9%), p=0.9. In addition, LBW rates were registered at 11.7% prior to pregnancy versus 11.6% after conception (p=0.9). The ART started during pregnancy <28 weeks pregnancy was almost twice associated to a higher risk of LBW odd ratio (1.87: 1.02-3.44, p<0.05). Conclusion: ART prior to conception mainly free of protease inhibitor does not increase the risk of PTB or LBW in Yaoundé, Cameroon.