@article{fdi:010079321,
  title = {{P}erinatal antiretroviral intensification to prevent intrapartum {HIV} transmission when antenatal antiretroviral therapy is initiated less than 8 weeks before delivery},
  author = {{L}allemant, {M}arc and {A}mzal, {B}. and {S}ripan, {P}. and {U}rien, {S}. and {C}ressey, {T}. {R}. and {N}go-{G}iang-{H}uong, {N}icole and {K}linbuayaem, {V}. and {R}awangban, {B}. and {S}absanong, {P}. and {S}iriwachirachai, {T}. and {J}arupanich, {T}. and {K}anjanavikai, {P}. and {W}anasiri, {P}. and {K}oetsawang, {S}. and {J}ourdain, {G}onzague and {L}e {C}oeur, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction: {I}nfants born to women living with {HIV} initiating combination antiretroviral therapy (c{ART}) late in pregnancy are at high risk of intrapartum infection. {M}other/infant perinatal antiretroviral intensification may substantially reduce this risk. {M}ethods: {I}n this single-arm {B}ayesian trial, pregnant women with {HIV} receiving standard of care antiretroviral prophylaxis in {T}hailand (maternal antenatal lopinavir-based c{ART}; nonbreastfed infants 4 weeks' postnatal zidovudine) were offered "antiretroviral intensification" (labor single-dose nevirapine plus infant zidovudine-lamivudine-nevirapine for 2 weeks followed by zidovudine-lamivudine for 2 weeks) if their antenatal c{ART} was initiated <= 8 weeks before delivery. {A} negative birth {HIV}-{DNA} polymerase chain reaction ({PCR}) followed by a confirmed positive {PCR} defined intrapartum transmission. {B}efore study initiation, we modeled intrapartum transmission probabilities using data from 3738 mother/infant pairs enrolled in our previous trials in {T}hailand using a logistic model, with perinatal maternal/infant antiretroviral regimen and predicted viral load at delivery as main covariates. {U}sing the characteristics of the women enrolled who received intensification, prior intrapartum transmission probabilities (credibility intervals) with/without intensification were estimated. {A}fter including the transmission data observed in the current study, the corresponding {B}ayesian posterior transmission probability was derived. {R}esults: {N}o intrapartum transmission of {HIV} was observed among the 88 mother/infant pairs receiving intensification. {T}he estimated intrapartum transmission probability was 2 center dot 2% (95% credibility interval 0 center dot 5-6 center dot 1) without intensification versus 0 center dot 3% (0 center dot 0-1 center dot 6) with intensification. {T}he probability of superiority of intensification over standard of care was 94 center dot 4%. {A}ntiretroviral intensification appeared safe. {C}onclusion: {M}other/infant antiretroviral intensification was effective in preventing intrapartum transmission of {HIV} in pregnant women receiving <= 8 weeks antepartum c{ART}.},
  keywords = {{HIV} ; prevention of mother-to-child transmission ; {B}ayesian design ; antiretroviral therapy ; clinical trial ; historical control ; meta-analysis ; {T}hailand ; {THAILANDE}},
  booktitle = {},
  journal = {{JAIDS} : {J}ournal of {A}cquired {I}mmune {D}eficiency {S}yndromes},
  volume = {84},
  numero = {3},
  pages = {313--322},
  ISSN = {1525-4135},
  year = {2020},
  DOI = {10.1097/qai.0000000000002350},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079321},
}