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No benefit to elective C-section for HIV patients with low viral loads. (Analysis of 2,087 Deliveries).
SEATTLE -- Performing an elective cesarean section on an HIV-infected mother with a viral load of less than 1,000 RNA copies/mL does not improve the rate of perinatal HIV transmission.
That finding emerged from an analysis of 2,087 HIV-positive pregnancies delivered between 1998 and June 2000.
When the mothers had a viral load below 1,000 RNA copies/mL, the rate of transmission was 0.8% for both women who delivered vaginally and those who delivered via elective cesarean section before the onset of labor or rupture of membranes, David Shapiro, Ph.D., said at the Ninth Conference on Retroviruses and Opportunistic Infections.
"What I take from these data is that the first objective should be to get the viral load down," Dr. Shapiro, a researcher at the Harvard School of Public Health, Boston, said in an interview.
The study also showed that there were significant differences in the way HIV-positive women were treated and delivered at the beginning and end of the study, and these differences had a large impact on transmission rates, he said. Overall, the study, which analyzed delivery records at 67 institutions, included 76 mother-to-infant transmissions, for a total transmission rate of 3.6%.
Although 30% of the women delivered in 1998 were on an antiretroviral regimen containing a protease inhibitor, 50% of those who delivered in 2000 were on such a regimen. Sixty percent of the women who delivered in 2000 had undetectable viral loads.
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Source: HighBeam Research, No benefit to elective C-section for HIV patients with low viral...