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Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015
Objectives Pregnancy and post‐partum viral load suppression is critical to prevent mother‐to‐child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV‐infected women. Methods Between 2010 and 2015, 1425 HIV‐infected pregnant women on lifel...
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| Published in: | Tropical medicine & international health 2018-01, Vol.23 (1), p.79-91 |
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| creator | Chetty, Terusha Newell, Marie‐Louise Thorne, Claire Coutsoudis, Anna |
| description | Objectives
Pregnancy and post‐partum viral load suppression is critical to prevent mother‐to‐child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV‐infected women.
Methods
Between 2010 and 2015, 1425 HIV‐infected pregnant women on lifelong antiretroviral therapy (ART) for at least six months pre‐pregnancy were enrolled in a cohort study in rural KwaZulu‐Natal, South Africa. Odds ratios were estimated in multilevel logistic regression, with pregnancy period time‐varying.
Results
Over half of 1425 women received tenofovir‐based regimens (n = 791). Median pre‐pregnancy ART duration was 2.1 years. Of 988 women (69.3%) with pre‐pregnancy viral loads, 82.0%, 6.8% and 11.2% had VL |
| doi_str_mv | 10.1111/tmi.13001 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7612915</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1983892813</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4431-35c603656d1f424002500cdef998c1ab163a8959a9063d3839f20419823389f63</originalsourceid><addsrcrecordid>eNp1kc9u1DAQxiMEoqVw4AWQJS4gbVr_Sdz4UqmqgK4ocKD0wMXyOuNdV4m9OE5Xe-sjgHjDPgnT3VIBEr6MZf_m0zfzFcVzRvcZnoPc-30mKGUPil0mZF0KVsuHmzstOT-UO8WTYbiklFZVLR8XO1wxzvC-W_y48MlA7w2ZgYsJJqQdkw9zYkJLjMuQyDLBPJhg18QHcjq9uLn-7oMDm6Elq9hDIDEgnn2CnOIV6nUkLyCZ5aYjjbcP71fm69iN2PvRZNNNyOc45gU5dslbMyGcMnpz_RNL_bR45Ew3wLO7uld8efvm_OS0PPv0bnpyfFbaqhKsFLWVFGeVLXMVryjlNaW2BadUY5mZMSlMo2plFJWiFY1QjtOKqYYL0SgnxV5xtNVdjrMeWgsho1G9TL43aa2j8frvn-AXeh6v9KFkuL8aBV7dCaT4bYQh694PFrrOBIjjoJmSAncveYPoy3_QyzimgOMh1aAf3jCB1OstZVMchgTu3gyj-jZojUHrTdDIvvjT_T35O1kEDrbAynew_r-SPv8w3Ur-ApHJs70</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1983892813</pqid></control><display><type>article</type><title>Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015</title><source>Wiley</source><creator>Chetty, Terusha ; Newell, Marie‐Louise ; Thorne, Claire ; Coutsoudis, Anna</creator><creatorcontrib>Chetty, Terusha ; Newell, Marie‐Louise ; Thorne, Claire ; Coutsoudis, Anna</creatorcontrib><description>Objectives
Pregnancy and post‐partum viral load suppression is critical to prevent mother‐to‐child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV‐infected women.
Methods
Between 2010 and 2015, 1425 HIV‐infected pregnant women on lifelong antiretroviral therapy (ART) for at least six months pre‐pregnancy were enrolled in a cohort study in rural KwaZulu‐Natal, South Africa. Odds ratios were estimated in multilevel logistic regression, with pregnancy period time‐varying.
Results
Over half of 1425 women received tenofovir‐based regimens (n = 791). Median pre‐pregnancy ART duration was 2.1 years. Of 988 women (69.3%) with pre‐pregnancy viral loads, 82.0%, 6.8% and 11.2% had VL <50, 50‐999 and ≥1000 copies/ml, respectively. During pregnancy and at six, 12 and 24 months, viral load was ≥1000 copies/ml in 15.2%, 15.7%, 17.8% and 16.6% respectively; viral load <50 was 76.9%, 77%, 75.5% and 75.8%, respectively. Adjusting for age, clinical and pregnancy factors, viraemia risk (viral load ≥50 copies/ml) was not significantly associated with pregnancy [adjusted OR (aOR) 1.31; 95% CI 0.90‐1.92], six months (aOR 1.30; 95% CI 0.83‐2.04), 12 months (aOR 0.96; 95% CI 0.58‐1.58) and 24 months (aOR 1.40; 95% CI 0.89‐2.22) post‐partum. Adjusting for ART duration–pregnancy period interaction, viraemia risk was 1.8 during pregnancy and twofold higher post‐partum.
Conclusions
While undetectable viral load before pregnancy through post‐partum was common, the UNAIDS goal to suppress viraemia in 90% of women was not met. Women on preconception ART remain vulnerable to viraemia; additional support is required to prevent mother‐to‐child HIV transmission and maintain maternal health.
Objectifs
La suppression de la charge virale pendant la grossesse et après l'accouchement est essentielle pour prévenir la transmission mère‐enfant du VIH et assurer la santé maternelle. Nous avons mesuré le risque de virémie avant, pendant et après la grossesse chez les femmes infectées par le VIH.
Méthodes
Entre 2010 et 2015, 1425 femmes enceintes infectées par le VIH, sous traitement antirétroviral (ART) à vie pendant au moins six mois avant la grossesse ont été incluses dans une étude de cohorte dans le KwaZulu‐Natal, en Afrique du Sud. Les odds ratios ont été estimés dans une régression logistique à multi niveaux, avec des périodes de grossesse variables.
Résultats
Plus de la moitié des 1425 femmes ont reçu un traitement à base de ténofovir (n = 791). La durée médiane de l’ART avant la grossesse était de 2,1 ans. Sur 988 femmes (69,3%) ayant des charges virales avant la grossesse, 82,0%, 6,8% et 11,2% avaient respectivement des valeurs de <50, entre 50 et 999, et ≥1000 copies/ml. Pendant la grossesse et à six, 12 et 24 mois, la charge virale était ≥1000 copies/ml chez 15,2%, 15,7%, 17,8% et 16,6% respectivement; elle était <50 chez 76,9%, 77%, 75,5% et 75,8%, respectivement. En ajustant pour l’âge, les facteurs cliniques et de grossesse, le risque de virémie (charge virale ≥ 50 copies/ml) n’était pas significativement associé à la grossesse [OR ajusté (aOR)= 1,31; IC95%: 0,90‐1,92], à six mois (aOR= 1,30; IC95%: 0,83‐2,04), à 12 mois (aOR= 0,96; IC95% : 0,58‐1,58) et à 24 mois (aOR= 1,40; IC95%: 0,89‐2,22) après l'accouchement. En ajustant pour l'interaction entre la durée de l’ART et la période de grossesse, le risque de virémie était de 1,8 pendant la grossesse et de deux fois plus élevé après l'accouchement.
Conclusions
Alors qu'une charge virale indétectable avant la grossesse et jusqu'au post‐partum était courante, l'objectif de l’ONUSIDA de supprimer la virémie chez 90% des femmes n’était pas atteint. Les femmes sous TAR avant la conception restent vulnérables à la virémie. Un soutien supplémentaire est nécessaire pour prévenir la transmission mère‐enfant du VIH et maintenir la santé maternelle.</description><identifier>ISSN: 1360-2276</identifier><identifier>EISSN: 1365-3156</identifier><identifier>DOI: 10.1111/tmi.13001</identifier><identifier>PMID: 29121445</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>adolescent ; adolescents ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Disease transmission ; Drug therapy ; Duration ; grossesse ; Health risks ; HIV ; HIV infection ; Human immunodeficiency virus ; infection VIH ; Maternal & child health ; Multilevel ; post‐partum ; Pregnancy ; Ratios ; Risk ; Risk factors ; Rural areas ; Tenofovir ; Therapy ; viraemia ; Viremia ; virémie ; Womens health</subject><ispartof>Tropical medicine & international health, 2018-01, Vol.23 (1), p.79-91</ispartof><rights>2017 John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>2018 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4431-35c603656d1f424002500cdef998c1ab163a8959a9063d3839f20419823389f63</citedby><cites>FETCH-LOGICAL-c4431-35c603656d1f424002500cdef998c1ab163a8959a9063d3839f20419823389f63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29121445$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chetty, Terusha</creatorcontrib><creatorcontrib>Newell, Marie‐Louise</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><creatorcontrib>Coutsoudis, Anna</creatorcontrib><title>Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015</title><title>Tropical medicine & international health</title><addtitle>Trop Med Int Health</addtitle><description>Objectives
Pregnancy and post‐partum viral load suppression is critical to prevent mother‐to‐child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV‐infected women.
Methods
Between 2010 and 2015, 1425 HIV‐infected pregnant women on lifelong antiretroviral therapy (ART) for at least six months pre‐pregnancy were enrolled in a cohort study in rural KwaZulu‐Natal, South Africa. Odds ratios were estimated in multilevel logistic regression, with pregnancy period time‐varying.
Results
Over half of 1425 women received tenofovir‐based regimens (n = 791). Median pre‐pregnancy ART duration was 2.1 years. Of 988 women (69.3%) with pre‐pregnancy viral loads, 82.0%, 6.8% and 11.2% had VL <50, 50‐999 and ≥1000 copies/ml, respectively. During pregnancy and at six, 12 and 24 months, viral load was ≥1000 copies/ml in 15.2%, 15.7%, 17.8% and 16.6% respectively; viral load <50 was 76.9%, 77%, 75.5% and 75.8%, respectively. Adjusting for age, clinical and pregnancy factors, viraemia risk (viral load ≥50 copies/ml) was not significantly associated with pregnancy [adjusted OR (aOR) 1.31; 95% CI 0.90‐1.92], six months (aOR 1.30; 95% CI 0.83‐2.04), 12 months (aOR 0.96; 95% CI 0.58‐1.58) and 24 months (aOR 1.40; 95% CI 0.89‐2.22) post‐partum. Adjusting for ART duration–pregnancy period interaction, viraemia risk was 1.8 during pregnancy and twofold higher post‐partum.
Conclusions
While undetectable viral load before pregnancy through post‐partum was common, the UNAIDS goal to suppress viraemia in 90% of women was not met. Women on preconception ART remain vulnerable to viraemia; additional support is required to prevent mother‐to‐child HIV transmission and maintain maternal health.
Objectifs
La suppression de la charge virale pendant la grossesse et après l'accouchement est essentielle pour prévenir la transmission mère‐enfant du VIH et assurer la santé maternelle. Nous avons mesuré le risque de virémie avant, pendant et après la grossesse chez les femmes infectées par le VIH.
Méthodes
Entre 2010 et 2015, 1425 femmes enceintes infectées par le VIH, sous traitement antirétroviral (ART) à vie pendant au moins six mois avant la grossesse ont été incluses dans une étude de cohorte dans le KwaZulu‐Natal, en Afrique du Sud. Les odds ratios ont été estimés dans une régression logistique à multi niveaux, avec des périodes de grossesse variables.
Résultats
Plus de la moitié des 1425 femmes ont reçu un traitement à base de ténofovir (n = 791). La durée médiane de l’ART avant la grossesse était de 2,1 ans. Sur 988 femmes (69,3%) ayant des charges virales avant la grossesse, 82,0%, 6,8% et 11,2% avaient respectivement des valeurs de <50, entre 50 et 999, et ≥1000 copies/ml. Pendant la grossesse et à six, 12 et 24 mois, la charge virale était ≥1000 copies/ml chez 15,2%, 15,7%, 17,8% et 16,6% respectivement; elle était <50 chez 76,9%, 77%, 75,5% et 75,8%, respectivement. En ajustant pour l’âge, les facteurs cliniques et de grossesse, le risque de virémie (charge virale ≥ 50 copies/ml) n’était pas significativement associé à la grossesse [OR ajusté (aOR)= 1,31; IC95%: 0,90‐1,92], à six mois (aOR= 1,30; IC95%: 0,83‐2,04), à 12 mois (aOR= 0,96; IC95% : 0,58‐1,58) et à 24 mois (aOR= 1,40; IC95%: 0,89‐2,22) après l'accouchement. En ajustant pour l'interaction entre la durée de l’ART et la période de grossesse, le risque de virémie était de 1,8 pendant la grossesse et de deux fois plus élevé après l'accouchement.
Conclusions
Alors qu'une charge virale indétectable avant la grossesse et jusqu'au post‐partum était courante, l'objectif de l’ONUSIDA de supprimer la virémie chez 90% des femmes n’était pas atteint. Les femmes sous TAR avant la conception restent vulnérables à la virémie. Un soutien supplémentaire est nécessaire pour prévenir la transmission mère‐enfant du VIH et maintenir la santé maternelle.</description><subject>adolescent</subject><subject>adolescents</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Disease transmission</subject><subject>Drug therapy</subject><subject>Duration</subject><subject>grossesse</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV infection</subject><subject>Human immunodeficiency virus</subject><subject>infection VIH</subject><subject>Maternal & child health</subject><subject>Multilevel</subject><subject>post‐partum</subject><subject>Pregnancy</subject><subject>Ratios</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Rural areas</subject><subject>Tenofovir</subject><subject>Therapy</subject><subject>viraemia</subject><subject>Viremia</subject><subject>virémie</subject><subject>Womens health</subject><issn>1360-2276</issn><issn>1365-3156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc9u1DAQxiMEoqVw4AWQJS4gbVr_Sdz4UqmqgK4ocKD0wMXyOuNdV4m9OE5Xe-sjgHjDPgnT3VIBEr6MZf_m0zfzFcVzRvcZnoPc-30mKGUPil0mZF0KVsuHmzstOT-UO8WTYbiklFZVLR8XO1wxzvC-W_y48MlA7w2ZgYsJJqQdkw9zYkJLjMuQyDLBPJhg18QHcjq9uLn-7oMDm6Elq9hDIDEgnn2CnOIV6nUkLyCZ5aYjjbcP71fm69iN2PvRZNNNyOc45gU5dslbMyGcMnpz_RNL_bR45Ew3wLO7uld8efvm_OS0PPv0bnpyfFbaqhKsFLWVFGeVLXMVryjlNaW2BadUY5mZMSlMo2plFJWiFY1QjtOKqYYL0SgnxV5xtNVdjrMeWgsho1G9TL43aa2j8frvn-AXeh6v9KFkuL8aBV7dCaT4bYQh694PFrrOBIjjoJmSAncveYPoy3_QyzimgOMh1aAf3jCB1OstZVMchgTu3gyj-jZojUHrTdDIvvjT_T35O1kEDrbAynew_r-SPv8w3Ur-ApHJs70</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Chetty, Terusha</creator><creator>Newell, Marie‐Louise</creator><creator>Thorne, Claire</creator><creator>Coutsoudis, Anna</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201801</creationdate><title>Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015</title><author>Chetty, Terusha ; Newell, Marie‐Louise ; Thorne, Claire ; Coutsoudis, Anna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4431-35c603656d1f424002500cdef998c1ab163a8959a9063d3839f20419823389f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>adolescent</topic><topic>adolescents</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Disease transmission</topic><topic>Drug therapy</topic><topic>Duration</topic><topic>grossesse</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV infection</topic><topic>Human immunodeficiency virus</topic><topic>infection VIH</topic><topic>Maternal & child health</topic><topic>Multilevel</topic><topic>post‐partum</topic><topic>Pregnancy</topic><topic>Ratios</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Rural areas</topic><topic>Tenofovir</topic><topic>Therapy</topic><topic>viraemia</topic><topic>Viremia</topic><topic>virémie</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chetty, Terusha</creatorcontrib><creatorcontrib>Newell, Marie‐Louise</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><creatorcontrib>Coutsoudis, Anna</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Tropical medicine & international health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chetty, Terusha</au><au>Newell, Marie‐Louise</au><au>Thorne, Claire</au><au>Coutsoudis, Anna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015</atitle><jtitle>Tropical medicine & international health</jtitle><addtitle>Trop Med Int Health</addtitle><date>2018-01</date><risdate>2018</risdate><volume>23</volume><issue>1</issue><spage>79</spage><epage>91</epage><pages>79-91</pages><issn>1360-2276</issn><eissn>1365-3156</eissn><abstract>Objectives
Pregnancy and post‐partum viral load suppression is critical to prevent mother‐to‐child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV‐infected women.
Methods
Between 2010 and 2015, 1425 HIV‐infected pregnant women on lifelong antiretroviral therapy (ART) for at least six months pre‐pregnancy were enrolled in a cohort study in rural KwaZulu‐Natal, South Africa. Odds ratios were estimated in multilevel logistic regression, with pregnancy period time‐varying.
Results
Over half of 1425 women received tenofovir‐based regimens (n = 791). Median pre‐pregnancy ART duration was 2.1 years. Of 988 women (69.3%) with pre‐pregnancy viral loads, 82.0%, 6.8% and 11.2% had VL <50, 50‐999 and ≥1000 copies/ml, respectively. During pregnancy and at six, 12 and 24 months, viral load was ≥1000 copies/ml in 15.2%, 15.7%, 17.8% and 16.6% respectively; viral load <50 was 76.9%, 77%, 75.5% and 75.8%, respectively. Adjusting for age, clinical and pregnancy factors, viraemia risk (viral load ≥50 copies/ml) was not significantly associated with pregnancy [adjusted OR (aOR) 1.31; 95% CI 0.90‐1.92], six months (aOR 1.30; 95% CI 0.83‐2.04), 12 months (aOR 0.96; 95% CI 0.58‐1.58) and 24 months (aOR 1.40; 95% CI 0.89‐2.22) post‐partum. Adjusting for ART duration–pregnancy period interaction, viraemia risk was 1.8 during pregnancy and twofold higher post‐partum.
Conclusions
While undetectable viral load before pregnancy through post‐partum was common, the UNAIDS goal to suppress viraemia in 90% of women was not met. Women on preconception ART remain vulnerable to viraemia; additional support is required to prevent mother‐to‐child HIV transmission and maintain maternal health.
Objectifs
La suppression de la charge virale pendant la grossesse et après l'accouchement est essentielle pour prévenir la transmission mère‐enfant du VIH et assurer la santé maternelle. Nous avons mesuré le risque de virémie avant, pendant et après la grossesse chez les femmes infectées par le VIH.
Méthodes
Entre 2010 et 2015, 1425 femmes enceintes infectées par le VIH, sous traitement antirétroviral (ART) à vie pendant au moins six mois avant la grossesse ont été incluses dans une étude de cohorte dans le KwaZulu‐Natal, en Afrique du Sud. Les odds ratios ont été estimés dans une régression logistique à multi niveaux, avec des périodes de grossesse variables.
Résultats
Plus de la moitié des 1425 femmes ont reçu un traitement à base de ténofovir (n = 791). La durée médiane de l’ART avant la grossesse était de 2,1 ans. Sur 988 femmes (69,3%) ayant des charges virales avant la grossesse, 82,0%, 6,8% et 11,2% avaient respectivement des valeurs de <50, entre 50 et 999, et ≥1000 copies/ml. Pendant la grossesse et à six, 12 et 24 mois, la charge virale était ≥1000 copies/ml chez 15,2%, 15,7%, 17,8% et 16,6% respectivement; elle était <50 chez 76,9%, 77%, 75,5% et 75,8%, respectivement. En ajustant pour l’âge, les facteurs cliniques et de grossesse, le risque de virémie (charge virale ≥ 50 copies/ml) n’était pas significativement associé à la grossesse [OR ajusté (aOR)= 1,31; IC95%: 0,90‐1,92], à six mois (aOR= 1,30; IC95%: 0,83‐2,04), à 12 mois (aOR= 0,96; IC95% : 0,58‐1,58) et à 24 mois (aOR= 1,40; IC95%: 0,89‐2,22) après l'accouchement. En ajustant pour l'interaction entre la durée de l’ART et la période de grossesse, le risque de virémie était de 1,8 pendant la grossesse et de deux fois plus élevé après l'accouchement.
Conclusions
Alors qu'une charge virale indétectable avant la grossesse et jusqu'au post‐partum était courante, l'objectif de l’ONUSIDA de supprimer la virémie chez 90% des femmes n’était pas atteint. Les femmes sous TAR avant la conception restent vulnérables à la virémie. Un soutien supplémentaire est nécessaire pour prévenir la transmission mère‐enfant du VIH et maintenir la santé maternelle.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>29121445</pmid><doi>10.1111/tmi.13001</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1360-2276 |
| ispartof | Tropical medicine & international health, 2018-01, Vol.23 (1), p.79-91 |
| issn | 1360-2276 1365-3156 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7612915 |
| source | Wiley |
| subjects | adolescent adolescents Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Disease transmission Drug therapy Duration grossesse Health risks HIV HIV infection Human immunodeficiency virus infection VIH Maternal & child health Multilevel post‐partum Pregnancy Ratios Risk Risk factors Rural areas Tenofovir Therapy viraemia Viremia virémie Womens health |
| title | Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015 |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T18%3A30%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Viraemia%20before,%20during%20and%20after%20pregnancy%20in%20HIV%E2%80%90infected%20women%20on%20antiretroviral%20therapy%20in%20rural%20KwaZulu%E2%80%90Natal,%20South%20Africa,%202010%E2%80%932015&rft.jtitle=Tropical%20medicine%20&%20international%20health&rft.au=Chetty,%20Terusha&rft.date=2018-01&rft.volume=23&rft.issue=1&rft.spage=79&rft.epage=91&rft.pages=79-91&rft.issn=1360-2276&rft.eissn=1365-3156&rft_id=info:doi/10.1111/tmi.13001&rft_dat=%3Cproquest_pubme%3E1983892813%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4431-35c603656d1f424002500cdef998c1ab163a8959a9063d3839f20419823389f63%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1983892813&rft_id=info:pmid/29121445&rfr_iscdi=true |