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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in johannesburg, South Africa
Journal of Acquired Immune Deficiency Syndromes, Volume 54, No. 1, Year 2010
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Description
Background: Limited information exists about effects of different highly active antiretroviral therapy (HAART) regimens and duration of regimens on mother-to-child transmission (MTCT) of HIV among women in Africa who start treatment for advanced immunosuppression. Methods: Between January 2004 to August 2008, 1142 women were followed at antenatal antiretroviral clinics in Johannesburg. Predictors of MTCT (positive infant HIV DNA polymerase chain reaction at 4-6 weeks) were assessed with multivariate logistic regression. Results: Mean age was 30.2 years (SD = 5.0) and median baseline CD4 count was 161 cells per cubic millimeter (SD = 84.3). HAART duration at time of delivery was a mean 10.7 weeks (SD = 7.4) for the 85% of women who initiated treatment during pregnancy and 93.4 weeks (SD = 37.7) for those who became pregnant on HAART. Overall MTCT rate was 4.9% (43 of 874), with no differences detected between HAART regimens. MTCT rates were lower in women who became pregnant on HAART than those initiating HAART during pregnancy (0.7% versus 5.7%; P = 0.01). In the latter group, each additional week of treatment reduced odds of transmission by 8% (95% confidence interval: 0.87 to 0.99, P = 0.02). Conclusions: Late initiation of HAART is associated with increased risk of MTCT. Strategies are needed to facilitate earlier identification of HIV-infected women. © 2010 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Hoffman, Risa M.
United States, Los Angeles
David Geffen School of Medicine at Ucla
Black, V.
South Africa, Johannesburg
University of the Witwatersrand
Technau, Karl Günter
South Africa, Johannesburg
University of the Witwatersrand
van der Merwe, Karin Joan
South Africa, Johannesburg
University of the Witwatersrand
Currier, Judith Silverstein
United States, Los Angeles
David Geffen School of Medicine at Ucla
Coovadia, Ashraf Hassen
South Africa, Johannesburg
University of the Witwatersrand
Chersich, Matthew Francis
South Africa, Johannesburg
University of the Witwatersrand
Belgium, Ghent
Universiteit Gent
Statistics
Citations: 126
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e3181cf9979
ISSN:
15254135
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Locations
South Africa
Participants Gender
Female