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Selected hematologic and biochemical measurements in African HIV-infected and uninfected pregnant women and their infants: the HIV Prevention Trials Network 024 protocol.

Mwinga K, Vermund SH, Chen YQ, Mwatha A, Read JS, Urassa W, Carpenetti N, Valentine M, Goldenberg RL - BMC Pediatr (2009)

Bottom Line: At 4-6 weeks, HIV-infected infants had higher alanine aminotransferase measures than uninfected infants.Normative data in pregnant African women and their newborn infants are needed to guide the large-scale HIV care and treatment programs being scaled up throughout the continent.These laboratory measures will help interpret clinical data and assist in patient monitoring in a sub-Saharan Africa context.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Paediatrics of the University Teaching Hospital and the University of Zambia School of Medicine, and the Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. mwingak@zm.afro.who.int

ABSTRACT

Background: Reference values for hematological and biochemical assays in pregnant women and in newborn infants are based primarily on Caucasian populations. Normative data are limited for populations in sub-Saharan Africa, especially comparing women with and without HIV infection, and comparing infants with and without HIV infection or HIV exposure.

Methods: We determined HIV status and selected hematological and biochemical measurements in women at 20-24 weeks and at 36 weeks gestation, and in infants at birth and 4-6 weeks of age. All were recruited within a randomized clinical trial of antibiotics to prevent chorioamnionitis-associated mother-to-child transmission of HIV (HPTN024). We report nearly complete laboratory data on 2,292 HIV-infected and 367 HIV-uninfected pregnant African women who were representative of the public clinics from which the women were recruited. Nearly all the HIV-infected mothers received nevirapine prophylaxis at the time of labor, as did their infants after birth (always within 72 hours of birth, but typically within just a few hours at the four study sites in Malawi (2 sites), Tanzania, and Zambia.

Results: HIV-infected pregnant women had lower red blood cell counts, hemoglobin, hematocrit, and white blood cell counts than HIV-uninfected women. Platelet and monocyte counts were higher among HIV-infected women at both time points. At the 4-6-week visit, HIV-infected infants had lower hemoglobin, hematocrit and white blood cell counts than uninfected infants. Platelet counts were lower in HIV-infected infants than HIV-uninfected infants, both at birth and at 4-6 weeks of age. At 4-6 weeks, HIV-infected infants had higher alanine aminotransferase measures than uninfected infants.

Conclusion: Normative data in pregnant African women and their newborn infants are needed to guide the large-scale HIV care and treatment programs being scaled up throughout the continent. These laboratory measures will help interpret clinical data and assist in patient monitoring in a sub-Saharan Africa context.

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Patient recruitment and retention for the HIV Prevention Trials Network 024 randomized clinical trial protocol in Malawi, Tanzania, and Zambia.
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Figure 1: Patient recruitment and retention for the HIV Prevention Trials Network 024 randomized clinical trial protocol in Malawi, Tanzania, and Zambia.

Mentions: We enrolled 2,659 eligible pregnant women into HPTN024. Of these 2,659 women, 2,292 (86%) were HIV-infected and 367 (14%) were uninfected (Figure 1). There were 2,382 live born infants (2,052 born to HIV-infected women and 331 born to uninfected women). The mean gestational age at birth (n = 2382) was 38.4 (± 0.06) weeks using the new Ballard score. The mean birth weight in the study was 2,957 (± 11.8) grams. Infants born to HIV-infected mothers had a 37-gram lower mean birth weight compared to infants born to HIV-uninfected mothers (2980 grams ± 505; 95% ci: 2957–3005 vs. 3079 grams ± 515; 95% ci: 3023–3135; respectively; p = 0.002 by Student's t test). The mean head circumference was 34.6 (± 0.05) cm. The mean Apgar score at 1 minute was 8.2 (± 0.03) and was 9.6 (± 0.03) at 5 minutes.


Selected hematologic and biochemical measurements in African HIV-infected and uninfected pregnant women and their infants: the HIV Prevention Trials Network 024 protocol.

Mwinga K, Vermund SH, Chen YQ, Mwatha A, Read JS, Urassa W, Carpenetti N, Valentine M, Goldenberg RL - BMC Pediatr (2009)

Patient recruitment and retention for the HIV Prevention Trials Network 024 randomized clinical trial protocol in Malawi, Tanzania, and Zambia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2746190&req=5

Figure 1: Patient recruitment and retention for the HIV Prevention Trials Network 024 randomized clinical trial protocol in Malawi, Tanzania, and Zambia.
Mentions: We enrolled 2,659 eligible pregnant women into HPTN024. Of these 2,659 women, 2,292 (86%) were HIV-infected and 367 (14%) were uninfected (Figure 1). There were 2,382 live born infants (2,052 born to HIV-infected women and 331 born to uninfected women). The mean gestational age at birth (n = 2382) was 38.4 (± 0.06) weeks using the new Ballard score. The mean birth weight in the study was 2,957 (± 11.8) grams. Infants born to HIV-infected mothers had a 37-gram lower mean birth weight compared to infants born to HIV-uninfected mothers (2980 grams ± 505; 95% ci: 2957–3005 vs. 3079 grams ± 515; 95% ci: 3023–3135; respectively; p = 0.002 by Student's t test). The mean head circumference was 34.6 (± 0.05) cm. The mean Apgar score at 1 minute was 8.2 (± 0.03) and was 9.6 (± 0.03) at 5 minutes.

Bottom Line: At 4-6 weeks, HIV-infected infants had higher alanine aminotransferase measures than uninfected infants.Normative data in pregnant African women and their newborn infants are needed to guide the large-scale HIV care and treatment programs being scaled up throughout the continent.These laboratory measures will help interpret clinical data and assist in patient monitoring in a sub-Saharan Africa context.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Paediatrics of the University Teaching Hospital and the University of Zambia School of Medicine, and the Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. mwingak@zm.afro.who.int

ABSTRACT

Background: Reference values for hematological and biochemical assays in pregnant women and in newborn infants are based primarily on Caucasian populations. Normative data are limited for populations in sub-Saharan Africa, especially comparing women with and without HIV infection, and comparing infants with and without HIV infection or HIV exposure.

Methods: We determined HIV status and selected hematological and biochemical measurements in women at 20-24 weeks and at 36 weeks gestation, and in infants at birth and 4-6 weeks of age. All were recruited within a randomized clinical trial of antibiotics to prevent chorioamnionitis-associated mother-to-child transmission of HIV (HPTN024). We report nearly complete laboratory data on 2,292 HIV-infected and 367 HIV-uninfected pregnant African women who were representative of the public clinics from which the women were recruited. Nearly all the HIV-infected mothers received nevirapine prophylaxis at the time of labor, as did their infants after birth (always within 72 hours of birth, but typically within just a few hours at the four study sites in Malawi (2 sites), Tanzania, and Zambia.

Results: HIV-infected pregnant women had lower red blood cell counts, hemoglobin, hematocrit, and white blood cell counts than HIV-uninfected women. Platelet and monocyte counts were higher among HIV-infected women at both time points. At the 4-6-week visit, HIV-infected infants had lower hemoglobin, hematocrit and white blood cell counts than uninfected infants. Platelet counts were lower in HIV-infected infants than HIV-uninfected infants, both at birth and at 4-6 weeks of age. At 4-6 weeks, HIV-infected infants had higher alanine aminotransferase measures than uninfected infants.

Conclusion: Normative data in pregnant African women and their newborn infants are needed to guide the large-scale HIV care and treatment programs being scaled up throughout the continent. These laboratory measures will help interpret clinical data and assist in patient monitoring in a sub-Saharan Africa context.

Show MeSH
Related in: MedlinePlus