TITLE:
Do Protease Inhibitors Increase Preterm Births in Human Immunodeficiency Virus-Infected Patients?
AUTHORS:
Shauna F. Williams, Bart Holland, Ulas Bozdogan, Jesus R. Alvarez, Joseph J. Apuzzio, Arlene D. Bardeguez
KEYWORDS:
HIV; Pregnancy; Preterm Birth; Protease Inhibitors
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.3 No.3,
August
28,
2013
ABSTRACT: Objective: To compare preterm delivery (PTD) rates in
HIV-infected patients on a protease inhibitor (PI)-based and a PI-sparing
regimen. Study Design: This is a
retrospective review of records of HIV-infected pregnant women between 2000 and
2007 at University Hospital, Newark, NJ. Patients were grouped according to PI
exposure during pregnancy. Rates of preterm birth were compared, and the
analysis was performed irrespectively of the etiology or indication of the
preterm birth. Multivariate analysis including substance use, PI use, initial
CD4 count, and history of PTD was performed. Results: There were 129 pregnant women in the PI group and 59 in the PI-sparing group. The PTD rate
did not differ between the PI group and PI-sparing group (27.9% vs 25.4%, P = 0.72).
28.6% of those who delivered preterm had a previous PTD compared to 8.4% of
those who delivered at term (P = 0.0019). Patients who delivered preterm had a higher rate of substance use (37.3% vs 19.7%, P =
0.0128). In the multivariate analysis, only history of PTD was significant (P
= 0.018). Conclusion: Contrary to
other studies, PIs were not associated with PTD. Other known risk factors of
PTD, specifically past PTD and substance use, should be considered and targeted
for risk reduction during pregnancy.