Abstract
Amaç: Üçüncü basamak bir merkezde takip edilen 14 HIV (insan immün yetmezlik virüsü) pozitif gebe kadının perinatal sonuçlarını değerlendirmek.
Yöntemler: : Bu, Ankara Bilkent Şehir Hastanesi perinatoloji kliniğinde yürütülen retrospektif bir kohort çalışması olup çalışmaya 2020-2023 yılları arasında HIV pozitif tanısıyla takip edilen tüm gebeler dahil edildi Gebelerin demografik özellikleri, tanı zamanı, prenatal ve intrapartum dönemde aldıkları antiretroviral tedavi, bebeklere aldıkları antiretroviral tedavi ve süreleri, vertikal bulaşma oranları değerlendirildi.
Bulgular: Çalışmaya toplam 14 HIV pozitif gebe dahil edildi. Olguların 2'si (%14,28) birinci trimesterde, bir olgu (%7,14) ikinci trimesterde, 10 olgu (%71,42) üçüncü trimesterde ve bir olgu (%7,14) postpartum 10. günde idi. Hastalardan dokuzunun (%64,3) düzenli hastane takipleri ve düzenli tetkik ve tedavileri vardı. 5'i (%35,7) düzenli kontrollere gelmemiş ve düzenli tedavi görmemişti. Ortalama CD4+ sayısı 611±243 hücre/mm3, CD8+ sayısı ise 852±366 hücre/mm3 idi. Ortalama CD4/CD8 oranı 0,94±0,74 idi. Bir hastada annenin HIV plazma RNA kopya numarasına bakılmadı, 5 hastada sonuç negatif, 8 hastada ise pozitif çıktı. Medyan HIV RNA'sı 471 (aralık 0-106559) kopya/mL idi. Bebekler farklı zamanlarda doğdukları için 0-18 ay ve 18-40 ay olmak üzere 2 gruba ayrıldılar. Bebeklerin tamamı çocuk doktoru ve enfeksiyon hastalıkları uzmanı tarafından düzenli olarak takip edildi. Tüm bebeklere lamivudin/zidovudin ve raltegravir ile standart tedavi verildi. 18 ay sonra yapılan kontrollerde bebeklerin hiçbirinde HIV pozitifliğine rastlanmadı.
Sonuç: Sonuç olarak, annede HIV enfeksiyonu multidisipliner bir ekip tarafından uygun şekilde yönetildiğinde olumlu sonuçlarla ilişkili olduğu gözlenmiştir.
References
- 1. Govender RD, Hashim MJ, Khan MA, Mustafa H, Khan G. Global epidemiology of HIV/AIDS: a resurgence in North America and Europe. Journal of epidemiology and global health. 2021;11(3):296. 2. De Cock KM, Fowler MG, Mercier E, De Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Jama. 2000;283(9):1175-82. 3. Kalish LA, Pitt J, Lew J, Landesman S, Diaz C, Hershow R, et al. Defining the time of fetal or perinatal acquisition of human immunodeficiency virus type 1 infection on the basis of age at first positive culture. Journal of Infectious Diseases. 1997;175(3):712-5.
Abstract
Objective: To evaluate the perinatal outcomes of 14 HIV (human immunodeficiency virus) positive pregnant women followed up in a tertiary center.
Methods: This is a retrospective cohort study conducted in Ankara Bilkent City Hospital perinatology clinic. All pregnant women who were followed up with a diagnosis of HIV positive between 2020 and 2023 were included in the study. Demographic characteristics of pregnant women, time of diagnosis, antiretroviral treatment received in the prenatal and intrapartum period, antiretroviral treatment received by infants and duration, and vertical transmission rate were evaluated.
Results: A total of 14 HIV-positive pregnant women were included in the study. Two cases (14.28%) were in the first trimester, one case (7.14%) was in the second trimester, 10 cases( 71.42%) were in the third trimester, and one case (7.14%) was in the 10th postpartum day at first admission to hospital. Nine (64.3%) of the patients had regular hospital follow-ups with regular tests and treatment. While 5 (35.7%) did not attend regular follow-ups and did not receive regular treatment. The mean CD4+ count was 611±243 cell/mm3 and the CD8+ count was 852±366 cell/mm3. The mean CD4/CD8 ratio was 0.94±0.74. The maternal HIV plasma RNA copy number was not checked in one patient, the result was negative in 5 patients and was positive in the remaining 8 patients. The median HIV RNA was 471 ( range 0-106559) copy/mL. Since the infants were born at different times, they were divided into 2 groups: 0-18 months and 18-40 months. All babies were regularly followed up by a pediatrician and an infectious disease specialist. All infants were given standard treatment with lamivudine/zidovudine and raltegravir. HIV positivity was not detected in any of the babies in the controls performed after 18 months.
Conclusion: In conclusion, maternal HIV infection is associated with favorable outcomes if managed appropriately by a multidisciplinary team.
References
- 1. Govender RD, Hashim MJ, Khan MA, Mustafa H, Khan G. Global epidemiology of HIV/AIDS: a resurgence in North America and Europe. Journal of epidemiology and global health. 2021;11(3):296. 2. De Cock KM, Fowler MG, Mercier E, De Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Jama. 2000;283(9):1175-82. 3. Kalish LA, Pitt J, Lew J, Landesman S, Diaz C, Hershow R, et al. Defining the time of fetal or perinatal acquisition of human immunodeficiency virus type 1 infection on the basis of age at first positive culture. Journal of Infectious Diseases. 1997;175(3):712-5.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 30, 2024 |
| Submission Date | January 17, 2024 |
| Acceptance Date | February 28, 2024 |
| Published in Issue | Year 2024 Volume: 21 Issue: 3 |
