Introduction
To maximize maternal health and prevent HIV
transmission to the newborn, the use of antiretroviral
drug (ARV) in all HIV-infected pregnant women during
Chakornbandit B, et al. Comparison of Preterm Delivery Rates between 69
HIV-infected Pregnant Women Receiving HHAART Containing PIs and
HIV-infected Pregnant Women Receiving Zidovudine Monotherapy
VOL. 23, NO. 2, APRIL 2015 VOL. 23, NO. 2, APRIL 2015
pregnancy is recommended(1). In a setting of universal
prenatal HIV testing and counseling, highly active
antiretroviral therapy (HAART), and elective cesarean
delivery and breastfeeding avoidance, the rate of HIV
mother-to-child transmission (MTCT) is less than 1%(2).
HAART — or the antiretroviral drug combinations of
two nucleoside reverse transcriptase inhibitors (NRTIs)
— plus either a non-nucleoside reverse transcriptase
inhibitor (NNRTI) or a protease inhibitor (PI), has been
shown to effectively reduce the risk of vertical
transmission by adequate viral suppression in pregnant
women(1). HAART (mostly containing PIs) was widely
in use to prevent MTCT instead of zidovudine
monotherapy in the last decade. However, adverse
pregnancy outcomes associated with the use of these
drugs still need to be addressed and dealt with. Preterm
delivery is the complication of the highest concern,
although the mechanism remains unclear(3). There
have been reports, by many studies, of increased rates
of prematurity, with odd ratios (OR) in the range of
1.6–2.6 in pregnancy receiving HAART containing PIs
compared with monotherapy or no therapy(4-8). However,
some studies, including the meta-analysis and the
systematic review, did not confirm this association(9-14).
This study aimed to compare the preterm delivery
rates between HIV-infected pregnant women receiving
HAART containing PIs and HIV-infected pregnant
women receiving zidovudine monotherapy during
pregnancy in a single center cohort of Thai pregnant
women with HIV infection.