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Infectious Diseases in Obstetrics and Gynecology
Volume 2016, Article ID 4897501, 8 pages
http://dx.doi.org/10.1155/2016/4897501
Research Article

Antiretroviral Resistance and Pregnancy Characteristics of Women with Perinatal and Nonperinatal HIV Infection

1Department of Obstetrics and Gynecology, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 624, Charleston, SC 29425, USA
2Department of Obstetrics and Gynecology, University of Michigan, L4100 Women’s Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
3Department of Pediatrics, University of Colorado Anschutz Medical Campus, 12700 E. 19th Box B168, Aurora, CO 80045, USA
4Department of Medicine, Drexel University, 1427 Vine Street, 2nd Floor, Philadelphia, PA 19102, USA
5Department of Medicine, University of Rochester, 601 Elmwood Avenue, Box 689, Rochester, NY 14642, USA
6Department of Obstetrics and Gynecology, Washington University, 4921 Parkview Place, St. Louis, MO 63110, USA
7Department of Obstetrics and Gynecology, University of California, 350 Parnassus Avenue No. 908, San Francisco, CA 94117, USA
8Department of Obstetrics and Gynecology, University of British Columbia, 1190 Hornby Street, 4th Floor, Vancouver, BC, Canada V6Z 2K5

Received 18 January 2016; Revised 12 May 2016; Accepted 22 May 2016

Academic Editor: Bryan Larsen

Copyright © 2016 Gweneth B. Lazenby et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To compare HIV drug resistance in pregnant women with perinatal HIV (PHIV) and those with nonperinatal HIV (NPHIV) infection. Methods. We conducted a multisite cohort study of PHIV and NPHIV women from 2000 to 2014. Sample size was calculated to identify a fourfold increase in antiretroviral (ARV) drug resistance in PHIV women. Continuous variables were compared using Student’s -test and Wilcoxon rank-sum tests. Categorical variables were compared using and Fisher’s exact tests. Univariate analysis was used to determine factors associated with antiretroviral drug resistance. Results. Forty-one PHIV and 41 NPHIV participants were included. Women with PHIV were more likely to have drug resistance than those with NPHIV ((55% versus 17%, ), OR 6.0 (95% CI 1.0–34.8), ), including multiclass resistance (15% versus 0, ), and they were more likely to receive nonstandard ARVs during pregnancy (27% versus 5%, ). PHIV and NPHIV women had similar rates of preterm birth (11% versus 28%, ) and cesarean delivery (47% versus 46%, ). Two infants born to a single NPHIV woman acquired HIV infection. Conclusions. PHIV women have a high frequency of HIV drug resistance mutations, leading to nonstandard ARVs use during pregnancy. Despite nonstandard ARV use during pregnancy, PHIV women did not experience increased rates of adverse pregnancy outcomes.