Date of Award

January 2011

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Christian M. Pettker

Second Advisor

Steven F. Thung

Subject Area(s)

Obstetrics and gynecology

Abstract

The current recommendations for antiretroviral-naïve patients support initiating HIV-infected patients on a once-daily (QD) regimen. However, seropositive pregnant women are often initiated or changed to a twice-daily (BID) regimen due to the historical preference of zidovudine. Our 10-year retrospective cohort study aims to compare the efficacy and safety between QD (n = 20) and BID (n = 50) regimens in HIV-infected pregnant women. We hypothesize there will be no difference between the two dosing regimens. Using multivariate regression analysis to adjust for confounding variables, we found no statistical difference (adjusted odds ratio 0.26, 95% confidence interval 0.1,1.2; p = 0.099) in the quantity of patients who achieved a viral load < 50 copies/mL by the time of delivery between the QD group (80 percent) and the BID group (66 percent). Similarly, we found no difference in maternal or neonatal adverse effects including preterm delivery, low birth weight, and pregnancy complications between our two cohorts. In summary, our study suggests QD dosing is non-inferior to BID dosing and may be a safe alternative for the HIV-infected pregnant population.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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