Maternal CD4+ Cell Count Decline after Interruption of Antiretroviral Prophylaxis for the Prevention of Mother-to-Child Transmission of HIV 英文参考文献.docVIP

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Maternal CD4+ Cell Count Decline after Interruption of Antiretroviral Prophylaxis for the Prevention of Mother-to-Child Transmission of HIV 英文参考文献.doc

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MaternalCD4CellCountDeclineafterInterruptionofAntiretroviralProphylaxisforthePreventionofMother-to-ChildTransmissionofHIV英文参考文献

MaternalCD4+CellCountDeclineafterInterruptionof AntiretroviralProphylaxisforthePreventionofMother- to-ChildTransmissionofHIV DidierEkouevi1,2*,ElaineJ.Abrams3,4,MalkaSchlesinger5,LandonMyer6,NittayaPhanuphak7, RosalindJ.Carter3,fortheMTCT-PlusInitiative 1MTCT-PlusInitiativeProgramme,PACCI,Abidjan,Co?ted’Ivoire,2Unite′INSERM893,InstitutdeSante′Publiqued’Epide′miologieetdeDe′veloppement(ISPED),Universite′ VictorSegalen,Bordeaux,France,3InternationalCenterforAIDSCareandTreatmentPrograms(ICAP),MailmanSchoolofPublicHealth,ColumbiaUniversity,NewYork, New York, United States of America, 4College of Physicians and Surgeons, Columbia University, New York, New York, United States of America, 5Department of Biostatistics,MailmanSchoolofPublicHealth,ColumbiaUniversity,NewYork,NewYork,UnitedStatesofAmerica, 6CentreforInfectiousDiseasesEpidemiologyand Research,SchoolofPublicHealthandFamilyMedicine,UniversityofCapetown,Capetown,SouthAfrica,7ThaiRedCrossAIDSResearchCentre,Bangkok,Thailand Abstract Background:WeevaluatedmaternalCD4+cellcount(CD4+)declineafterPMTCTprophylaxisinamulti-countryHIVcare program. Methods:Analysiswasrestrictedtoantiretroviraltherapy(ART)-naive,HIV-infectedpregnantwomenwithCD4+$250cells/ 3 mm at enrollment. Single-dose nevirapine (sd-NVP) or short-course antiretroviral prophylaxis (sc-ARVp) with zidovudine (AZT)orAZT+lamivudine(3TC)wasinitiatedin11programswhile2programsofferedtriple-drugantiretroviralprophylaxis (tARVp)(AZT+3TC+NVPornelfinavir).Allregimenswerestoppedatdelivery.CD4+declinewasdefinedasproportionof women who declined to CD4+ ,350cells/mm3 or ,200cells/mm3 at 24months. Weibull regression was used for multivariableanalysis. Findings:Atotalof1,393womenwithenrollmentCD4+$250cells/mm3initiatedtARVp(172;12%)orsc-ARVp(532;38%) during pregnancy or received intrapartum sd-NVP (689; 50%). At enrollment, maternal median age was 27years (interquartile range (IQR) 23–30), median CD4+ was 469cells/mm3 (IQR: 363–613). At 24months post-delivery, the