@article{fdi:010093247,
  title = {{M}aternal anaemia and duration of zidovudine in antiretroviral regimens for preventing mother-to-child transmission : a randomized trial in three {A}frican countries},
  author = {{S}artorius, {B}.{K}.{D}. and {C}hersich, {M}.{F}. and {M}waura, {M}. and {M}eda, {N}. and {T}emmerman, {M}. and {N}ewell, {M}.{L}. and {F}arley, {T}.{M}.{M}. and {L}uchters, {S}. and {C}ournil, {A}mandine and et al.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {A}lthough substantiated by little evidence, concerns about zidovudine-related anaemia in pregnancy have influenced antiretroviral ({ARV}) regimen choice for preventing mother-to-child transmission of {HIV}-1, especially in settings where anaemia is common. {M}ethods: {E}ligible {HIV}-infected pregnant women in {B}urkina {F}aso, {K}enya and {S}outh {A}frica were followed from 28 weeks of pregnancy until 12-24 months after delivery (n = 1070). {W}omen with a {CD}4 count of 200 500cells/mm(3) and gestational age 28-36 weeks were randomly assigned to zidovudine-containing triple-{ARV} prophylaxis continued during breastfeeding up to 6-months, or to zidovudine during pregnancy plus single-dose nevirapine (sd-{NVP}) at labour. {A}dditionally, two cohorts were established, women with {CD}4 counts: <200 cells/mm(3) initiated antiretroviral therapy, and >500 cells/mm(3) received zidovudine during pregnancy plus sd-{NVP} at labour. {M}ild (haemoglobin 8.0-10.9 g/dl) and severe anaemia (haemoglobin < 8.0 g/dl) occurrence were assessed across study arms, using {K}aplan-{M}eier and multivariable {C}ox proportional hazards models. {R}esults: {A}t enrolment (corresponded to amedian 32 weeks gestation), median haemoglobin was 10.3 g/dl ({IQR} = 9.2-11.1). {S}evere anaemia occurred subsequently in 194 (18.1%) women, mostly in those with low baseline haemoglobin, lowest socio-economic category, advanced {HIV} disease, prolonged breastfeeding (>= 6 months) and shorter {ARV} exposure. {S}evere anaemia incidence was similar in the randomized arms (equivalence {P}-value = 0.32). {A}fter 1-2months of {ARV}'s, severe anaemia was significantly reduced in all groups, though remained highest in the low {CD}4 cohort. {C}onclusions: {S}evere anaemia occurs at a similar rate in women receiving longer triple zidovudine-containing regimens or shorter prophylaxis. {P}regnant women with pre-existing anaemia and advanced {HIV} disease require close monitoring.},
  keywords = {{BURKINA} {FASO} ; {KENYA} ; {AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {13},
  numero = {1},
  pages = {522 [14 ]},
  ISSN = {1471-2334},
  year = {2013},
  DOI = {10.1186/1471-2334-13-522},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093247},
}