TY - JOUR
T1 - HIV RNA Suppression during and after Pregnancy among Women in the HIV Outpatient Study, 1996 to 2015
AU - on behalf of the HOPS Investigators
AU - Patel, Monita
AU - Tedaldi, Ellen
AU - Armon, Carl
AU - Nesheim, Steven
AU - Lampe, Margaret
AU - Palella, Frank
AU - Novak, Richard
AU - Sutton, Madeline
AU - Buchacz, Kate
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The HOPS is funded by the Centers for Disease Control and Prevention (CDC, contract numbers: 200-2001-00133, 200-2006-18797, 200-2011-41872, and 200-2015-63931).
Publisher Copyright:
© The Author(s) 2018.
PY - 2018/1/20
Y1 - 2018/1/20
N2 - 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.
AB - 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.
KW - HIV
KW - postpartum
KW - pregnancy
KW - viral suppression
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U2 - 10.1177/2325957417752259
DO - 10.1177/2325957417752259
M3 - Article
C2 - 29357772
AN - SCOPUS:85059179060
SN - 2325-9574
VL - 17
JO - Journal of the International Association of Providers of AIDS Care
JF - Journal of the International Association of Providers of AIDS Care
ER -
