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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
PLoS ONE, Volume 8, No. 3, Article e59446, Year 2013
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Description
Objective: To investigate the factors associated with HIV1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin. Design: Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. Methods: HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART) for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. Results: Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area), regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. Conclusions: This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control. © 2013 Denoeud-Ndam et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3598754/bin/pone.0059446.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3598754/bin/pone.0059446.s002.doc
Authors & Co-Authors
Denoeud-Ndam, Lise
France, Marseille
Ird Institut de Recherche Pour le Developpement
Fourcade, Camille
France, Marseille
Ird Institut de Recherche Pour le Developpement
Ogouyèmi-Hounto, Aurore
Benin, Cotonou
Programme Santé de Lutte Contre le Sida Psls
Azon-Kouanou, Angèle
Benin
Centre National Hospitalier Universitaire Hubert Koutoukou Maga
D'Almeida, Marcelline
Benin
Centre National Hospitalier Universitaire Hubert Koutoukou Maga
Azondékon, Alain
Benin
Hôpital D’instruction Des Armées
Alao, Maroufou Jules
Benin
Hôpital de la Mère et de L'enfant Lagune
Dossou-Gbété, Véronique
Benin
Clinique Louis Pasteur
Afangnihoun, Aldric
Benin
Hôpital de Zone de Suru Léré
Girard, Pierre Marie
France, Paris
Hôpital Saint-antoine
France, Paris
Sorbonne Université
Cot, Michel
France, Marseille
Ird Institut de Recherche Pour le Developpement
Zannou, Djimon Marcel
Benin
Centre National Hospitalier Universitaire Hubert Koutoukou Maga
Benin, Cotonou
University of Abomey-calavi
Statistics
Citations: 12
Authors: 12
Affiliations: 10
Identifiers
Doi:
10.1371/journal.pone.0059446
e-ISSN:
19326203
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Benin
Participants Gender
Female