04). Among the 50 infants who were reported not to have received any prophylaxis, seven died within one week of delivery (including five born between 22 and 26 weeks click here of

gestation). Of the 43 surviving infants, 17 (39.5%) were born to women who received no antenatal antiretroviral therapy, at least eight of whom had reportedly declined all treatment interventions. Among infants who received prophylaxis, use of triple PEP increased significantly from 9.2% (297 of 3243) in 2001–2004 to 13.0% (624 of 4807) in 2005–2008 (P<0.001) (information on type of prophylaxis was missing for 105 infants). Over half of infants (54.4%; 86 of 158) born to untreated women received triple PEP, with an increase from 43.2% (41 of 95) in 2001–2004 to 71.4% (45 of 63) in 2005–2008 (P=0.001). Use of triple PEP also increased among infants born to women who were viraemic despite taking HAART, from 12.9% (114 of 883) in 2001–2004 to 31.6% (344 of 1088) in 2005–2008 (P<0.001), and was 23.2% (458 of 1971) overall. In analyses restricted to infants who received either single- or triple-drug prophylaxis, triple PEP was more common in 2005–2008 and was positively associated with lack of maternal antenatal treatment, shorter duration of maternal treatment, maternal receipt of intrapartum treatment, detectable maternal viral load, Entinostat ic50 CD4 count <200 cells/μL, emergency caesarean section or unplanned vaginal

delivery, and preterm delivery (<37 gestation weeks) (Table 2). These factors were all significantly associated with use of triple PEP in multivariable analysis adjusting for time period, type and duration of maternal antenatal antiretroviral therapy, intrapartum treatment, maternal viral load, maternal CD4 cell count, mode of delivery and gestational age. Since 2005, the BHIVA guidelines have recommended consideration of triple PEP for infants born to untreated mothers or women who remain viraemic despite HAART: between 2005 and 2008, a third of these infants (33.8%; 389 of 1151) received Lepirudin triple PEP. In this group, use of triple PEP was more common when maternal diagnosis occurred

in the last two weeks of pregnancy [94.1% (32 of 34) vs. 32.5% (355 of 1093) for earlier diagnosis; P<0.001], when maternal viral load was ≥1000 copies/mL [44.8% (155 of 346) vs. 28.5% (215 of 755) for viral load 50–999 copies/mL; P<0.001] and when maternal CD4 count was <200 cells/μL [43.2% (67 of 155) vs. 31.1% (282 of 908) for ≥200 cells/μL; P=0.004]. Use of triple PEP was also more common in infants born preterm (<37 weeks gestation) [46.5% (93 of 200) vs. 31.4% (290 of 923) for term infants; P<0.001] or by unplanned vaginal delivery [51.9% (27 of 52) vs. 32.5% (197 of 606) for elective caesarean section; P<0.001]. Ninety-four infants born at <28 weeks of gestation were reported, and information on receipt of PEP was available for 81 of these infants. Five infants died within one week of delivery and did not receive prophylaxis (described above).