Postnatal infant HIV prophylaxis: a survey of U.S. practice.

TitlePostnatal infant HIV prophylaxis: a survey of U.S. practice.
Publication TypeJournal Article
Year of Publication2011
AuthorsMcKeegan K, Rutstein RM, Lowenthal ED
JournalAIDS Patient Care STDS
Volume25
Issue1
Pagination1-4
Date Published2011 Jan
ISSN1557-7449
KeywordsAnti-HIV Agents, Data Collection, Drug Therapy, Combination, HIV Infections, Humans, Infant, Newborn, Odds Ratio, Risk Factors, United States, Viral Load
Abstract

For neonates identified as at increased risk of acquiring HIV perinatally, the optimal postnatal prophylaxis regimen is not known. Current United States Public Health Service guidelines recognize that combination postnatal prophylaxis may be considered in some situations but that there are little data regarding the effectiveness and safety of any postnatal regimen besides zidovudine. The actual use of combination postnatal regimens in the United States has not previously been described. We conducted a national, Web-based survey between December 2009 and January 2010 to describe the percent of providers who prescribe combination postnatal prophylaxis, the antiretroviral combinations they used, and the risk factors that might elicit combination postnatal prophylaxis. 472 known or possible perinatal HIV providers were queried; 42% (n = 197) responded and 68% of respondents (134) were eligible to complete the survey. Sixty-two percent (n = 83) of participating providers reported use or recommendation of combination postnatal prophylaxis in the last year. Three drugs, zidovudine, lamivudine and nevirapine, comprised 77% of first-choice combination regimens. Lopinivir-ritonivir (LPV/RTV) was included in 16% of all reported regimens. Combination postnatal prophylaxis was strongly preferred in patient-based scenarios with additional risk factors for perinatal HIV transmission.

DOI10.1089/apc.2010.0255
Alternate JournalAIDS Patient Care STDS
PubMed ID21162689