Sripan Patumrat auteur aut IRD Le Coeur S. auteur aut IRD Ingsrisawang L. auteur aut IRD Cressey T. R. auteur aut IRD Bouazza N. auteur aut IRD Foissac F. auteur aut IRD Ngo-Giang-Huong Nicole auteur aut IRD Traisathit P. auteur aut IRD Srirompotong U. auteur aut IRD Ayudhaya O. P. N. auteur aut IRD Puangsombat A. auteur aut IRD Jungpipun J. auteur aut IRD Jittayanun K. auteur aut IRD Treluyer J. M. auteur aut IRD Jourdain Gonzague auteur aut IRD Lallemant Marc auteur aut IRD Urien S. auteur aut IRD text journalArticle eng text/pdf born digital access Background: Antiretroviral (ARV) regimens used for the prevention of mother-to-child transmission of HIV have evolved over time. We evaluated the contribution of different ARV regimens on the reduction of the plasma HIV RNA viral load (VL) during pregnancy. Methods: A total of 1,833 VL measurements from ARV-naive pregnant women participating in perinatal prevention trials in Thailand were included. Women received either zidovudine (ZDV) monotherapy, ZDV plus lopinavir/ritonavir (LPV/r), or ZDV plus lamivudine (3TC) plus LPV/r. VL time-course during pregnancy was described as a function of pretreatment VL and treatment duration using an E max non-linear mixed-effect model. VL reduction and median time to achieve a VL< 50 copies/ml were estimated for each regimen. Results: Among 745 women, 279 (37%), 145 (20%) and 321 (43%) received ZDV monotherapy, ZDV+ LPV/r and ZDV+ 3TC+ LPV/r, respectively. The predicted VL reduction from baseline to delivery after a median of 10 weeks of treatment were 0.5, 2.7 and 2.9 log 10 copies/ml with ZDV monotherapy, ZDV+ LPV/r and ZDV+ 3TC+ LPV/r, respectively. At delivery, 1%, 57% and 63% of women receiving ZDV monotherapy, ZDV+ LPV/r or ZDV+ 3TC+ LPV/r had a VL< 50 copies/ml. The addition of 3TC to ZDV+ LPV/r reduced the time to achieve a VL< 50 copies/ml and the higher the pretreatment VL, the larger the effect 3TC had on reducing the time to VL< 50 copies/ml. Conclusions: The addition of 3TC to ZDV+ LPV/r was associated with a slight further VL reduction but the time to reach a VL< 50 copies/ml was shorter. This beneficial effect of 3TC is crucial for prevention of mother-to-child transmission in women who receive ARVs late and with high pretreatment VL. specialized THAILANDE 052 050 21 5 435-440 2016 1359-6535 https://www.documentation.ird.fr/hor/fdi:010069356 10.3851/imp3001 1359-6535 [F B010069356] https://www.documentation.ird.fr/hor/fdi:010069356 https://www.documentation.ird.fr/intranet/publi/2017/04/010069356.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2017-05-09 2017-08-23 fdi:010069356 fre