Objective: The objective of the study was to determine whether the duration of membrane rupture of 4 or more hours is a significant risk factor for perinatal transmission of human immunodeficiency virus (HIV) in the era of combination antiretroviral therapy (ART). Study Design: This was a prospective cohort study of 717 HIV-infected pregnant women-infant pairs with a delivery viral load available who received prenatal care and delivered at our institution during the interval 1996-2008. Results: The cohort comprised 707 women receiving ART who delivered during this interval. The perinatal transmission rate was 1% in women with membranes ruptured for less than 4 hours and 1.9% when ruptured for 4 or more hours. For 493 women with a delivery viral load less than 1000 copies/mL receiving combination ART in pregnancy, there were no cases of perinatal transmission identified up to 25 hours of membrane rupture. Logistic regression demonstrated only a viral load above 10,000 copies/mL as an independent risk factor for perinatal transmission. Conclusion: Duration of membrane rupture of 4 or more hours is not a risk factor for perinatal transmission of HIV in women with a viral load less than 1000 copies/mL receiving combination ART.
Duration of membrane rupture and risk of perinatal transmission of HIV-1 in the era of combination antiretroviral therapy. / Cotter, Amanda M.; Brookfield, Kathleen F.; Duthely, Lunthita; Gonzalez Quintero, Victor H.; Potter, JoNell E; O'Sullivan, Mary J.In: American Journal of Obstetrics and Gynecology, Vol. 207, No. 6, 01.12.2012.
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