@article{fdi:010064660,
  title = {{M}odeling of in-utero and intra-partum transmissions to evaluate the efficacy of interventions for the prevention of perinatal {HIV}},
  author = {{S}ripan, {P}. and {L}e {C}oeur, {S}ophie and {A}mzal, {B}. and {I}ngsrisawang, {L}. and {T}raisathit, {P}. and {N}go-{G}iang-{H}uong, {N}icole and {M}c{I}ntosh, {K}. and {C}ressey, {T}. {R}. and {S}angsawang, {S}. and {R}awangban, {B}. and {K}anjanavikai, {P}. and {T}reluyer, {J}. {M}. and {J}ourdain, {G}onzague and {L}allemant, {M}arc and {U}rien, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A}ntiretroviral treatments decrease {HIV} mother-to-child transmission through pre/post exposure prophylaxis and reduction of maternal viral load. {W}e modeled in-utero and intra-partum {HIV} transmissions to investigate the preventive role of various antiretroviral treatments interventions. {M}ethods {W}e analysed data from 3,759 women-infant pairs enrolled in 3 randomized clinical trials evaluating (1) zidovudine monotherapy, (2) zidovudine plus perinatal single-dose nevirapine or (3) zidovudine plus lopinavir/ritonavir for the prevention of mother-to-child transmission of {HIV} in {T}hailand. {A}ll infants were formula-fed. {N}on-linear mixed effect modeling was used to express the viral load evolution under antiretroviral treatments and the probability of transmission. {R}esults {M}edian viral load was 4 log(10) copies/m{L} ({I}nterquartile range: 3.36-4.56) before antiretroviral treatments initiation. {A}n {E}maxmodel described the viral load time-course during pregnancy. {H}alf of the maximum effect of zidovudine (28% decrease) and lopinavir/ritonavir (72% decrease) were achieved after 98 and 12 days, respectively. {A}djusted on viral load at baseline ({O}dds ratio = 1.50 [95% confidence interval: 1.34, 1.68] per log(10) copies/m{L} increment), anti-retroviral treatments duration ({OR} = 0.80 [0.75, 0.84] per week increment) but not the nature of antiretroviral treatments were associated with in-utero transmission. {A}djusted on gestational age at delivery (<37 weeks, {OR} = 2.37 [1.37, 4.10]), baseline {CD}4 ({O}dds ratio = 0.79 [0.72, 0.88] per 100 cells/mm(3) increment) and predicted viral load at delivery ({OR} = 1.47 [1.25, 1.64] per log(10) copies/m{L} increment), single-dose nevirapine considerably reduced intra-partum transmission ({OR} = 0.32 [0.2, 0.51]). {C}onclusion {T}hese models determined the respective contributions of various antiretroviral strategies on prevention of mother-to-child transmission. {T}his can help predict the efficacy of new antiretroviral treatments and/or prevention of mother-to-child transmission strategies particularly for women with no or late antenatal care who are at high risk of transmitting {HIV} to their offspring.},
  keywords = {{THAILANDE}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {10},
  numero = {5},
  pages = {e0126647 [16 p.]},
  ISSN = {1932-6203},
  year = {2015},
  DOI = {10.1371/journal.pone.0126647},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064660},
}