Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection
| Main Author: | |
|---|---|
| Publication Date: | 2012 |
| Other Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Article |
| Language: | eng |
| Source: | Repositório Institucional da FIOCRUZ (ARCA) |
| Download full: | https://www.arca.fiocruz.br/handle/icict/6404 |
Summary: | The Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD] and others |
| id |
CRUZ_13a78091a4cfd482c6c935d9cc673cd8 |
|---|---|
| oai_identifier_str |
oai:www.arca.fiocruz.br:icict/6404 |
| network_acronym_str |
CRUZ |
| network_name_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| repository_id_str |
2135 |
| spelling |
Saines, Karin NielsenWatts, HeatherSantos, Valdiléa Gonçalves Veloso dosBryson, Yvonne J.João Filho, Esaú CustódioPilotto, Jose Henrique da SilvaGray, Glenda E.Theron, GerhardSantos, Breno RiegelFonseca, Rosana Campos daKreitchmann, RegisPinto, JorgePinhata, Marisa Marcia MussiCeriotto, MarianaMachado, DaisyBethel, JamesMorgado, Mariza GonçalvesDickover, RuthCamarca, MargaretMirochnick, MarkSiberry, GeorgeGrinsztejn, BeatrizMoreira, RonaldoBastos, Francisco Inácio Pinkusfeld MonteiroXu, JiahongMoye, JackMofenson, Lynne M.2013-03-27T13:23:08Z2013-03-27T13:23:08Z2012NIELSEN-SAINES Karin et al. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection. The New England Journal of Medicine, Massachusetts, v. 366, n. 25, p. 2368-2379, 21 jun. 20120028-47931533-4406https://www.arca.fiocruz.br/handle/icict/640410.1056/NEJMoa1108275The Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD] and othersUniversity of California Los Angeles David Geffen School of Medicine, CA, Estados UnidosEunice Kennedy Shriver National Institute Of Child Health And Human Development. Maryland, MD, Estados UnidosFundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Centro de Pesquisa Clínica Em Hiv Aids.Riod e Janeiro, RJ, BrasilUniversity of California Los Angeles David Geffen School of Med icine, CA, Estados UnidosHospital dos Servidores do Estado, Rio de Janeiro, RJ, BrasilHospital Geral de Nova Iguaçu, Rio de Janeiro, RJ, BrasilUniversity of Witwatersrand. Perinatal HIV Research Unit. , South AfricaFaculty of Medicine. Department of Obstetrics and Gynecology.Tygerberg, South AfricaGrupo Hospitalar Conceição. Hospital Nossa Senhora da Conceição. Departamento de Doenças Infecciosas. Porto Alegre, RS, BrasilHospital Fêmina. Porto Alegre, RS, BrasilIrmandade da Santa Casa de Misericordia de Porto Alegre. Porto Alegre, RS, BrasilUniversidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Pediatria. Minas Gerais, MG, BrasilUniversidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Puericultura e Pediatria. Ribeirão Preto, SP, BrasilFoundation for Maternal and Infant Health, Buenos Aires, BS, ArgentinaUniversidade Federal de Sao Paulo. Sao Paulo, SP, BrasilThe Children's Hospital of Philadelphia Research Institute. Pensilvania, PA, Estados UnidosFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Imunologia. Rio de Janeiro, RJ, BrasilUniversity of California Davis, California, CA, Estados UnidosNational Institute of Child Health and Human Development . Maryland, MD, Estados UnidosBoston University School of Medicine. Massachusetts, MA, Estados UnidosEunice Kennedy Shriver National Institute Of Child Health And Human Development. Maryland, MD, Estados UnidosUniversity of Witwatersrand and Chris Hani Baragwanath Hospital.Johannesburgo, JNB, Africa do SulFundação Oswaldo Cruz.Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz.Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde. Rio de Janeiro, RJ, BrasilEunice Kennedy Shriver National Institute Of Child Health And Human Development. Maryland, MD, Estados UnidosEunice Kennedy Shriver National Institute Of Child Health And Human Development. Maryland, MD, Estados UnidosEunice Kennedy Shriver National Institute Of Child Health And Human Development. Maryland, MD, Estados UnidosBackground The safety and efficacy of adding antiretroviral drugs to standard zidovudine prophylaxis in infants of mothers with human immunodeficiency virus (HIV) infection who did not receive antenatal antiretroviral therapy (ART) because of late identification are unclear. We evaluated three ART regimens in such infants. Methods Within 48 hours after their birth, we randomly assigned formula-fed infants born to women with a peripartum diagnosis of HIV type 1 (HIV-1) infection to one of three regimens: zidovudine for 6 weeks (zidovudine-alone group), zidovudine for 6 weeks plus three doses of nevirapine during the first 8 days of life (two-drug group), or zidovudine for 6 weeks plus nelfinavir and lamivudine for 2 weeks (three-drug group). The primary outcome was HIV-1 infection at 3 months in infants uninfected at birth. Results A total of 1684 infants were enrolled in the Americas and South Africa (566 in the zidovudine-alone group, 562 in the two-drug group, and 556 in the three-drug group). The overall rate of in utero transmission of HIV-1 on the basis of Kaplan–Meier estimates was 5.7% (93 infants), with no significant differences among the groups. Intrapartum transmission occurred in 24 infants in the zidovudine-alone group (4.8%; 95% confidence interval [CI], 3.2 to 7.1), as compared with 11 infants in the two-drug group (2.2%; 95% CI, 1.2 to 3.9; P = 0.046) and 12 in the three-drug group (2.4%; 95% CI, 1.4 to 4.3; P = 0.046). The overall transmission rate was 8.5% (140 infants), with an increased rate in the zidovudine-alone group (P = 0.03 for the comparisons with the two- and three-drug groups). On multivariate analysis, zidovudine monotherapy, a higher maternal viral load, and maternal use of illegal substances were significantly associated with transmission. The rate of neutropenia was significantly increased in the three-drug group (P<0.001 for both comparisons with the other groups). Conclusions In neonates whose mothers did not receive ART during pregnancy, prophylaxis with a two- or three-drug ART regimen is superior to zidovudine alone for the prevention of intrapartum HIV transmission; the two-drug regimen has less toxicity than the threedrug regimen.engMassachusetts Medical SocietyThree Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infectioninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleKaplan-Meier EstimateAntiretroviral Therapy, Highly Active /utilizationZidovudine /therapeutic usePrenatal Diagnosis /utilizationHIV-1 /pathogenicityNevirapine /therapeutic useHIV Antigens /therapeutic useAmericas /epidemiologyAfrica /epidemiologyEstimativa de Kaplan-MeierTerapia Antirretroviral de Alta Atividade /utilizaçãoZidovudina /uso terapêuticoDiagnóstico Pré-Natal /utilizaçãoHIV-1 /patogenicidadeNevirapina /uso terapêuticoAntígenos HIV /uso terapêuticoAméricas /epidemiologiaÁfrica /epidemiologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALThree Postpartum Antiretroviral Regimens.pdfThree Postpartum Antiretroviral Regimens.pdfapplication/pdf294824https://www.arca.fiocruz.br/bitstream/icict/6404/2/Three%20Postpartum%20Antiretroviral%20Regimens.pdf90af1d7b9e587f1ac38e86d95ee5ee38MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81914https://www.arca.fiocruz.br/bitstream/icict/6404/3/license.txt7d48279ffeed55da8dfe2f8e81f3b81fMD53TEXTThree Postpartum Antiretroviral Regimens.pdf.txtThree Postpartum Antiretroviral Regimens.pdf.txtExtracted texttext/plain51829https://www.arca.fiocruz.br/bitstream/icict/6404/6/Three%20Postpartum%20Antiretroviral%20Regimens.pdf.txt43ca750ea7e8fd99576ae5ac04aa5b8bMD56THUMBNAILThree Postpartum Antiretroviral Regimens.pdf.jpgThree Postpartum Antiretroviral Regimens.pdf.jpgGenerated Thumbnailimage/jpeg2180https://www.arca.fiocruz.br/bitstream/icict/6404/5/Three%20Postpartum%20Antiretroviral%20Regimens.pdf.jpgaf2c67eb307ad4a370291b7f77bec45fMD55icict/64042023-08-23 15:29:33.761oai:www.arca.fiocruz.br:icict/6404TElDRU7Dh0EgREUgRElTVFJJQlVJw4fDg08gTsODTy1FWENMVVNJVkEKCkFvIGNvbmNvcmRhciBlIGFjZWl0YXIgZXN0YSBsaWNlbsOnYSB2b2PDqiAoYXV0b3Igb3UgZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzKToKCmEpIERlY2xhcmEgcXVlIGNvbmhlY2UgYSBwb2zDrXRpY2EgZGUgY29weXJpZ2h0IGRhIGVkaXRvcmEgZG8gc2V1IGRvY3VtZW50by4KCmIpIERlY2xhcmEgcXVlIGNvbmhlY2UgZSBhY2VpdGEgYXMgRGlyZXRyaXplcyBwYXJhIG8gUmVwb3NpdMOzcmlvIEluc3RpdHVjaW9uYWwgZGEgRnVuZGHDp8OjbyBPc3dhbGRvIENydXogKEZJT0NSVVopLgoKYykgQ29uY2VkZSDDoCBGSU9DUlVaIG8gZGlyZWl0byBuw6NvLWV4Y2x1c2l2byBkZSBhcnF1aXZhciwgcmVwcm9kdXppciwgY29udmVydGVyIChjb21vIGRlZmluaWRvIGEgc2VndWlyKSwgY29tdW5pY2FyCiAKZS9vdSBkaXN0cmlidWlyIG5vIFJlcG9zaXTDs3JpbyBkYSBGSU9DUlVaLCBvIGRvY3VtZW50byBlbnRyZWd1ZSAoaW5jbHVpbmRvIG8gcmVzdW1vL2Fic3RyYWN0KSBlbSBmb3JtYXRvIGRpZ2l0YWwgb3UgCgpwb3IgcXVhbHF1ZXIgb3V0cm8gbWVpby4KCmQpIERlY2xhcmEgcXVlIGF1dG9yaXphIGEgRklPQ1JVWiBhIGFycXVpdmFyIG1haXMgZGUgdW1hIGPDs3BpYSBkZXN0ZSBkb2N1bWVudG8gZSBjb252ZXJ0w6otbG8sIHNlbSBhbHRlcmFyIG8gc2V1IGNvbnRlw7pkbywgCgpwYXJhIHF1YWxxdWVyIGZvcm1hdG8gZGUgYXJxdWl2bywgbWVpbyBvdSBzdXBvcnRlLCBwYXJhIGVmZWl0b3MgZGUgc2VndXJhbsOnYSwgcHJlc2VydmHDp8OjbyAoYmFja3VwKSBlIGFjZXNzby4KCmUpIERlY2xhcmEgcXVlIG8gZG9jdW1lbnRvIHN1Ym1ldGlkbyDDqSBvIHNldSB0cmFiYWxobyBvcmlnaW5hbCwgZSBxdWUgZGV0w6ltIG8gZGlyZWl0byBkZSBjb25jZWRlciBhIHRlcmNlaXJvcyBvcyBkaXJlaXRvcyAKCmNvbnRpZG9zIG5lc3RhIGxpY2Vuw6dhLiBEZWNsYXJhIHRhbWLDqW0gcXVlIGEgZW50cmVnYSBkbyBkb2N1bWVudG8gbsOjbyBpbmZyaW5nZSBvcyBkaXJlaXRvcyBkZSBxdWFscXVlciBvdXRyYSBwZXNzb2Egb3UgZW50aWRhZGUuCgpmKSBEZWNsYXJhIHF1ZSwgbm8gY2FzbyBkbyBkb2N1bWVudG8gc3VibWV0aWRvIGNvbnRlciBtYXRlcmlhbCBkbyBxdWFsIG7Do28gZGV0w6ltIG9zIGRpcmVpdG9zIGRlIGF1dG9yLCBvYnRldmUgYSBhdXRvcml6YcOnw6NvIAoKaXJyZXN0cml0YSBkbyByZXNwZWN0aXZvIGRldGVudG9yIGRlc3NlcyBkaXJlaXRvcywgcGFyYSBjZWRlciBhIEZJT0NSVVogb3MgZGlyZWl0b3MgcmVxdWVyaWRvcyBwb3IgZXN0YSBMaWNlbsOnYSBlIGF1dG9yaXphciBhIAoKdXRpbGl6w6EtbG9zIGxlZ2FsbWVudGUuIERlY2xhcmEgdGFtYsOpbSBxdWUgZXNzZSBtYXRlcmlhbCBjdWpvcyBkaXJlaXRvcyBzw6NvIGRlIHRlcmNlaXJvcyBlc3TDoSBjbGFyYW1lbnRlIGlkZW50aWZpY2FkbyBlIHJlY29uaGVjaWRvIAoKbm8gdGV4dG8gb3UgY29udGXDumRvIGRvIGRvY3VtZW50byBlbnRyZWd1ZS4KCmcpIFNFIE8gRE9DVU1FTlRPIEVOVFJFR1VFIMOJIEJBU0VBRE8gRU0gVFJBQkFMSE8gRklOQU5DSUFETyBPVSBBUE9JQURPIFBPUiBPVVRSQSBJTlNUSVRVScOHw4NPIFFVRSBOw4NPIEEgRklPQ1JVWiwgREVDTEFSQSBRVUUgQ1VNUFJJVSAKClFVQUlTUVVFUiBPQlJJR0HDh8OVRVMgRVhJR0lEQVMgUEVMTyBSRVNQRUNUSVZPIENPTlRSQVRPIE9VIEFDT1JETy4gQSBGSU9DUlVaIGlkZW50aWZpY2Fyw6EgY2xhcmFtZW50ZSBvKHMpIG5vbWUocykgZG8ocykgYXV0b3IoZXMpIGRvcyAKCmRpcmVpdG9zIGRvIGRvY3VtZW50byBlbnRyZWd1ZSBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIHBhcmEgYWzDqW0gZG8gcHJldmlzdG8gbmEgYWzDrW5lYSBjKS4KRepositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-08-23T18:29:33Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.pt_BR.fl_str_mv |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| title |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| spellingShingle |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection Saines, Karin Nielsen Kaplan-Meier Estimate Antiretroviral Therapy, Highly Active /utilization Zidovudine /therapeutic use Prenatal Diagnosis /utilization HIV-1 /pathogenicity Nevirapine /therapeutic use HIV Antigens /therapeutic use Americas /epidemiology Africa /epidemiology Estimativa de Kaplan-Meier Terapia Antirretroviral de Alta Atividade /utilização Zidovudina /uso terapêutico Diagnóstico Pré-Natal /utilização HIV-1 /patogenicidade Nevirapina /uso terapêutico Antígenos HIV /uso terapêutico Américas /epidemiologia África /epidemiologia |
| title_short |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| title_full |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| title_fullStr |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| title_full_unstemmed |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| title_sort |
Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection |
| author |
Saines, Karin Nielsen |
| author_facet |
Saines, Karin Nielsen Watts, Heather Santos, Valdiléa Gonçalves Veloso dos Bryson, Yvonne J. João Filho, Esaú Custódio Pilotto, Jose Henrique da Silva Gray, Glenda E. Theron, Gerhard Santos, Breno Riegel Fonseca, Rosana Campos da Kreitchmann, Regis Pinto, Jorge Pinhata, Marisa Marcia Mussi Ceriotto, Mariana Machado, Daisy Bethel, James Morgado, Mariza Gonçalves Dickover, Ruth Camarca, Margaret Mirochnick, Mark Siberry, George Grinsztejn, Beatriz Moreira, Ronaldo Bastos, Francisco Inácio Pinkusfeld Monteiro Xu, Jiahong Moye, Jack Mofenson, Lynne M. |
| author_role |
author |
| author2 |
Watts, Heather Santos, Valdiléa Gonçalves Veloso dos Bryson, Yvonne J. João Filho, Esaú Custódio Pilotto, Jose Henrique da Silva Gray, Glenda E. Theron, Gerhard Santos, Breno Riegel Fonseca, Rosana Campos da Kreitchmann, Regis Pinto, Jorge Pinhata, Marisa Marcia Mussi Ceriotto, Mariana Machado, Daisy Bethel, James Morgado, Mariza Gonçalves Dickover, Ruth Camarca, Margaret Mirochnick, Mark Siberry, George Grinsztejn, Beatriz Moreira, Ronaldo Bastos, Francisco Inácio Pinkusfeld Monteiro Xu, Jiahong Moye, Jack Mofenson, Lynne M. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Saines, Karin Nielsen Watts, Heather Santos, Valdiléa Gonçalves Veloso dos Bryson, Yvonne J. João Filho, Esaú Custódio Pilotto, Jose Henrique da Silva Gray, Glenda E. Theron, Gerhard Santos, Breno Riegel Fonseca, Rosana Campos da Kreitchmann, Regis Pinto, Jorge Pinhata, Marisa Marcia Mussi Ceriotto, Mariana Machado, Daisy Bethel, James Morgado, Mariza Gonçalves Dickover, Ruth Camarca, Margaret Mirochnick, Mark Siberry, George Grinsztejn, Beatriz Moreira, Ronaldo Bastos, Francisco Inácio Pinkusfeld Monteiro Xu, Jiahong Moye, Jack Mofenson, Lynne M. |
| dc.subject.en.pt_BR.fl_str_mv |
Kaplan-Meier Estimate Antiretroviral Therapy, Highly Active /utilization Zidovudine /therapeutic use Prenatal Diagnosis /utilization HIV-1 /pathogenicity Nevirapine /therapeutic use HIV Antigens /therapeutic use Americas /epidemiology Africa /epidemiology |
| topic |
Kaplan-Meier Estimate Antiretroviral Therapy, Highly Active /utilization Zidovudine /therapeutic use Prenatal Diagnosis /utilization HIV-1 /pathogenicity Nevirapine /therapeutic use HIV Antigens /therapeutic use Americas /epidemiology Africa /epidemiology Estimativa de Kaplan-Meier Terapia Antirretroviral de Alta Atividade /utilização Zidovudina /uso terapêutico Diagnóstico Pré-Natal /utilização HIV-1 /patogenicidade Nevirapina /uso terapêutico Antígenos HIV /uso terapêutico Américas /epidemiologia África /epidemiologia |
| dc.subject.decs.pt_BR.fl_str_mv |
Estimativa de Kaplan-Meier Terapia Antirretroviral de Alta Atividade /utilização Zidovudina /uso terapêutico Diagnóstico Pré-Natal /utilização HIV-1 /patogenicidade Nevirapina /uso terapêutico Antígenos HIV /uso terapêutico Américas /epidemiologia África /epidemiologia |
| description |
The Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD] and others |
| publishDate |
2012 |
| dc.date.issued.fl_str_mv |
2012 |
| dc.date.accessioned.fl_str_mv |
2013-03-27T13:23:08Z |
| dc.date.available.fl_str_mv |
2013-03-27T13:23:08Z |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.citation.fl_str_mv |
NIELSEN-SAINES Karin et al. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection. The New England Journal of Medicine, Massachusetts, v. 366, n. 25, p. 2368-2379, 21 jun. 2012 |
| dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/6404 |
| dc.identifier.issn.none.fl_str_mv |
0028-4793 1533-4406 |
| dc.identifier.doi.none.fl_str_mv |
10.1056/NEJMoa1108275 |
| identifier_str_mv |
NIELSEN-SAINES Karin et al. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection. The New England Journal of Medicine, Massachusetts, v. 366, n. 25, p. 2368-2379, 21 jun. 2012 0028-4793 1533-4406 10.1056/NEJMoa1108275 |
| url |
https://www.arca.fiocruz.br/handle/icict/6404 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.publisher.none.fl_str_mv |
Massachusetts Medical Society |
| publisher.none.fl_str_mv |
Massachusetts Medical Society |
| dc.source.none.fl_str_mv |
reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
| instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
| instacron_str |
FIOCRUZ |
| institution |
FIOCRUZ |
| reponame_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| collection |
Repositório Institucional da FIOCRUZ (ARCA) |
| bitstream.url.fl_str_mv |
https://www.arca.fiocruz.br/bitstream/icict/6404/2/Three%20Postpartum%20Antiretroviral%20Regimens.pdf https://www.arca.fiocruz.br/bitstream/icict/6404/3/license.txt https://www.arca.fiocruz.br/bitstream/icict/6404/6/Three%20Postpartum%20Antiretroviral%20Regimens.pdf.txt https://www.arca.fiocruz.br/bitstream/icict/6404/5/Three%20Postpartum%20Antiretroviral%20Regimens.pdf.jpg |
| bitstream.checksum.fl_str_mv |
90af1d7b9e587f1ac38e86d95ee5ee38 7d48279ffeed55da8dfe2f8e81f3b81f 43ca750ea7e8fd99576ae5ac04aa5b8b af2c67eb307ad4a370291b7f77bec45f |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ) |
| repository.mail.fl_str_mv |
repositorio.arca@fiocruz.br |
| _version_ |
1798324807541981184 |