%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Sartorius, B.K.D.
%A Chersich, M.F.
%A Mwaura, M.
%A Meda, N.
%A Temmerman, M.
%A Newell, M.L.
%A Farley, T.M.M.
%A Luchters, S.
%A Cournil, Amandine
%A et al.
%T Maternal anaemia and duration of zidovudine in antiretroviral regimens for preventing mother-to-child transmission : a randomized trial in three African countries
%D 2013
%L fdi:010093247
%G ENG
%J BMC Infectious Diseases
%@ 1471-2334
%K BURKINA FASO ; KENYA ; AFRIQUE DU SUD
%M ISI:000328905300001
%N 1
%P 522 [14 ]
%R 10.1186/1471-2334-13-522
%U https://www.documentation.ird.fr/hor/fdi:010093247
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-04/010093247.pdf
%V 13
%W Horizon (IRD)
%X Background: Although 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. Methods: Eligible HIV-infected pregnant women in Burkina Faso, Kenya and South Africa were followed from 28 weeks of pregnancy until 12-24 months after delivery (n = 1070). Women with a CD4 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. Additionally, two cohorts were established, women with CD4 counts: <200 cells/mm(3) initiated antiretroviral therapy, and >500 cells/mm(3) received zidovudine during pregnancy plus sd-NVP at labour. Mild (haemoglobin 8.0-10.9 g/dl) and severe anaemia (haemoglobin < 8.0 g/dl) occurrence were assessed across study arms, using Kaplan-Meier and multivariable Cox proportional hazards models. Results: At enrolment (corresponded to amedian 32 weeks gestation), median haemoglobin was 10.3 g/dl (IQR = 9.2-11.1). Severe 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. Severe anaemia incidence was similar in the randomized arms (equivalence P-value = 0.32). After 1-2months of ARV's, severe anaemia was significantly reduced in all groups, though remained highest in the low CD4 cohort. Conclusions: Severe anaemia occurs at a similar rate in women receiving longer triple zidovudine-containing regimens or shorter prophylaxis. Pregnant women with pre-existing anaemia and advanced HIV disease require close monitoring.
%$ 054PHYMED ; 052MALTRA03