Horizon 1 1 17 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES JAIDS : Journal of Acquired Immune Deficiency Syndromes 313-322 HIV prevention of mother-to-child transmission Bayesian design antiretroviral therapy clinical trial historical control meta-analysis Thailand THAILANDE 2020 fdi:010079321 ENG JAIDS : Journal of Acquired Immune Deficiency Syndromes 1525-4135 ISI:000546317200013 3 10.1097/qai.0000000000002350 https://www.documentation.ird.fr/hor/fdi:010079321 https://www.documentation.ird.fr/intranet/publi/2020/08/010079321.pdf 84 Horizon (IRD) Introduction: Infants born to women living with HIV initiating combination antiretroviral therapy (cART) late in pregnancy are at high risk of intrapartum infection. Mother/infant perinatal antiretroviral intensification may substantially reduce this risk. Methods: In this single-arm Bayesian trial, pregnant women with HIV receiving standard of care antiretroviral prophylaxis in Thailand (maternal antenatal lopinavir-based cART; 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 cART was initiated <= 8 weeks before delivery. A negative birth HIV-DNA polymerase chain reaction (PCR) followed by a confirmed positive PCR defined intrapartum transmission. Before study initiation, we modeled intrapartum transmission probabilities using data from 3738 mother/infant pairs enrolled in our previous trials in Thailand using a logistic model, with perinatal maternal/infant antiretroviral regimen and predicted viral load at delivery as main covariates. Using the characteristics of the women enrolled who received intensification, prior intrapartum transmission probabilities (credibility intervals) with/without intensification were estimated. After including the transmission data observed in the current study, the corresponding Bayesian posterior transmission probability was derived. Results: No intrapartum transmission of HIV was observed among the 88 mother/infant pairs receiving intensification. The 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. The probability of superiority of intensification over standard of care was 94 center dot 4%. Antiretroviral intensification appeared safe. Conclusion: Mother/infant antiretroviral intensification was effective in preventing intrapartum transmission of HIV in pregnant women receiving <= 8 weeks antepartum cART. 050 ; 052 UR174 Thaïlande