%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Balasubramanian, R.
%A Fowler, M. G.
%A Dominguez, K.
%A Lockman, S.
%A Tookey, P. A.
%A Huong, N. N. G.
%A Nesheim, S.
%A Hughes, M. D.
%A Lallemant, Marc
%A Tosswill, J.
%A Shaffer, N.
%A Sherman, G.
%A Palumbo, P.
%A Shapiro, D. E.
%T Time to first positive HIV-1 DNA PCR may differ with antiretroviral regimen in infants infected with non-B subtype HIV-1
%D 2017
%L fdi:010071905
%G ENG
%J Aids
%@ 0269-9370
%K DNA PCR assays ; early infant diagnosis of HIV ; mother-to-child ; transmission of HIV
%K BOTSWANA ; THAILANDE ; ROYAUME UNI
%M ISI:000417766300004
%N 18
%P 2465-2474
%R 10.1097/qad.0000000000001640
%U https://www.documentation.ird.fr/hor/fdi:010071905
%> https://www.documentation.ird.fr/intranet/publi/2018/01/010071905.pdf
%V 31
%W Horizon (IRD)
%X Objective: To evaluate the association of type and timing of prophylactic maternal and infant antiretroviral regimen with time to first positive HIV-1 DNA PCR test, in nonbreastfed HIV-infected infants, from populations infected predominantly with HIV-1 non-B subtype virus. Design: Analysis of combined data on nonbreastfed HIV-infected infants from prospective cohorts in Botswana, Thailand, and the United Kingdom (N = 405). Methods: Parametric models appropriate for interval-censored outcomes estimated the time to first positive PCR according to maternal or infant antiretroviral regimen category and timing of maternal antiretroviral initiation, with adjustment for covariates. Results: Maternal antiretroviral regimens included: no antiretrovirals (n = 138), single-nucleoside analog reverse transcriptase inhibitor (n = 165), single-dose nevirapine with zidovudine (n = 66), and combination prophylaxis with 3 or more antiretrovirals [combination antiretroviral therapy (cART), n = 36]. Type of maternal/infant antiretroviral regimen and timing of maternal antiretroviral initiation were each significantly associated with time to first positive PCR (multivariate P < 0.0001). The probability of a positive test with no antiretrovirals compared with the other regimen/timing groups was significantly lower at 1 day after birth, but did not differ significantly after age 14 days. In a subgroup of 143 infants testing negative at birth, infant cART was significantly associated with longer time to first positive test (multivariate P = 0.04). Conclusion: Time to first positive HIV-1 DNA PCR in HIV-1-infected nonbreastfed infants (non-B HIV subtype) may differ according to maternal/infant antiretroviral regimen and may be longer with infant cART, which may have implications for scheduling infant HIV PCR-diagnostic testing and confirming final infant HIV status.
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