Antiviral Therapy 14:423–432

Original article Pregnancy outcomes in women with HIV type-1 receiving a lopinavir/ritonavir-containing regimen Elie Azria1,2,3*, Constance Moutafoff 2, Thomas Schmitz1,2, Jean Patrick Le Meaux 2, Anne Krivine 4, Emmanuelle Pannier 2, Ghislaine Firtion2, Alexandra Compagnucci5, Laurent Finkielsztejn2, Olivier Taulera2, Vassilis Tsatsaris1,2, Dominique Cabrol1,2 and Odile Launay 1,6 Université Paris Descartes, Faculté de Médecine, Paris, France Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Saint-Vincent de Paul, Department of Gynaecology and Obstetrics, Port Royal Maternity, Paris, France 3 Present address: Université Paris Diderot, Faculté de médecine; AP-HP, Hôpital Bichat Claude Bernard, Department of Gynaecology and Obstetrics, Paris, France 4 AP-HP, Groupe Hospitalier Cochin Saint-Vincent de Paul, Service de Virologie, Paris, France 5 AP-HP, Groupe Hospitalier Cochin Saint-Vincent de Paul, Pôle de Médecine, Paris, France 6 AP-HP, Groupe Hospitalier Cochin Saint-Vincent de Paul, Pôle de Médecine, CIC de Vaccinologie Cochin Pasteur, EA3620, Paris, France 1 2

*Corresponding author: E-mail: [email protected]

Background: The pregnancy-related adverse effects of antiretroviral therapy (ART) have yielded discordant results, which could be explained in part by the heterogeneity of ART protocols. The objective of our study was to explore whether lopinavir/ritonavir (LPV/r) exposure during pregnancy is associated with adverse outcomes. Methods: Data on 100 consecutive HIV type-1 (HIV- 1)-­ infected women receiving LPV/r during pregnancy and who delivered after 15 weeks gestational age (GA) between January 2003 and June 2007 in a single centre were analysed. For each HIV-1-infected woman, two uninfected women matched by age, parity and geographical origin were selected among patients delivering during the same period. Preterm delivery (PTD), vasculoplacental complications, gestational glucose intolerance and post-partum complication rates were compared between cases and controls. Factors associated with PTD and post-partum

complications were assessed in HIV-1-infected women by a logistic regression model. Results: Rates of vasculoplacental complication and gestational glucose intolerance were not higher among HIV-1-infected women than in controls. PTD was higher in HIV-1-infected women (21%) than in controls (10%; P0.25. For the study of PTD, variables included in the model at the first step of variable selection were maternal age at delivery, parity, history of PTD, LPV/r-based ART exposure before 14  weeks GA, CDC stage, CD4+ T-cell count categories, HIV-1 RNA level categories Antiviral Therapy 14.3

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and HIV-1 RNA