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J Int Assoc Provid AIDS Care. 2018 Jan-Dec;17:2325957417752259. doi: 10.1177/2325957417752259.

HIV RNA Suppression during and after Pregnancy among Women in the HIV Outpatient Study, 1996 to 2015.

Author information

1
1 Centers for Disease Control and Prevention, Atlanta, GA, USA.
2
2 Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
3
3 Cerner Corporation, Kansas City, MO, USA.
4
4 Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
5
5 University of Illinois at Chicago, Chicago, IL, USA.

Abstract

OBJECTIVE:

To examine HIV viral suppression during/after pregnancy.

DESIGN:

Prospective observational cohort.

METHODS:

We identified pregnancies from 1996 to 2015. We examined HIV RNA viral load (VL), VL suppression (≤500 copies/mL), and antiretroviral therapy (ART) status at pregnancy start, end, and 6 months postpartum. We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for VL nonsuppression.

RESULTS:

Among 253 pregnancies analyzed, 34.8% of women exhibited VL suppression at pregnancy start, 60.1% at pregnancy end, and 42.7% at 6 months postpartum. Median VL (log10 copies/mL) was 2.80 (interquartile range [IQR]: 1.40-3.85) at pregnancy start, 1.70 (IQR: 1.40-2.82) at pregnancy end, and 2.30 (IQR: 1.40-3.86) at postpartum. Risk of postpartum VL nonsuppression was also lower among women on ART and with VL suppression at pregnancy end (versus those not; adjusted RR = 0.30, 95% CI: 0.17-0.53).

CONCLUSIONS:

Maintaining VL suppression among US women remains a challenge, particularly during postpartum. Achieving VL suppression earlier during pregnancy benefits women subsequently.

KEYWORDS:

HIV; postpartum; pregnancy; viral suppression

PMID:
29357772
DOI:
10.1177/2325957417752259

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