دورية أكاديمية
أعرض في EDS

Effects of the timing of maternal antiretroviral therapy initiation, CD4 count, and HIV viral load on birth outcomes in the Eastern Cape province of South Africa: A secondary data analysis.

التفاصيل البيبلوغرافية
العنوان: Effects of the timing of maternal antiretroviral therapy initiation, CD4 count, and HIV viral load on birth outcomes in the Eastern Cape province of South Africa: A secondary data analysis.
المؤلفون: Siqithi S; Department of Paediatrics, Cecilia Makiwane Hospital, Walter Sisulu University, East London, South Africa., Durojaiye OC; Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, United Kingdom.; Department of Microbiology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, Derbyshire, United Kingdom., Adeniyi OV; Department of Family Medicine, Cecilia Makiwane Hospital, Walter Sisulu University, East London, South Africa.
المصدر: PloS one [PLoS One] 2024 Sep 06; Vol. 19 (9), pp. e0308374. Date of Electronic Publication: 2024 Sep 06 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: HIV Infections*/drug therapy , HIV Infections*/virology , Viral Load* , Pregnancy Complications, Infectious*/drug therapy , Pregnancy Complications, Infectious*/virology , Pregnancy Outcome*, Humans ; Female ; Pregnancy ; South Africa/epidemiology ; Adult ; CD4 Lymphocyte Count ; Infant, Newborn ; Premature Birth/epidemiology ; Infectious Disease Transmission, Vertical/prevention & control ; Young Adult ; Infant, Low Birth Weight ; Anti-HIV Agents/therapeutic use ; Stillbirth/epidemiology ; Secondary Data Analysis
مستخلص: Background: Antiretroviral therapy (ART) use during pregnancy is essential to prevent vertical transmission of HIV, but it may also increase the risk of adverse birth outcomes. This study investigated the impact of both maternal HIV infection and the timing of ART initiation on birth outcomes in women living with HIV in South Africa.
Methods: This secondary data analysis examined the dataset from an earlier cohort study involving 1709 pregnant women living with HIV who delivered their babies at three major maternity centres in the Eastern Cape province of South Africa between September 2015 and May 2018. The associations between adverse birth outcomes (stillbirth, preterm birth, very preterm birth, and low birth weight) and the timing of maternal ART initiation, peripartum CD4 count, and HIV viral load were examined using logistic regression analysis.
Results: The observed rates of stillbirth, preterm birth, very preterm birth, and low birth weight were 1.4%, 33.5%, 5.4% and 18.0%, respectively. In the multivariable analysis, low birth weight was associated with ART initiated during the second trimester (adjusted odds ratio [aOR] 1.38; 95% confidence interval [CI], 1.03-1.85), low-level viraemia (21-999 copies/ml) (aOR, 1.62; 95% CI, 1.17-2.22), and high-level viraemia (≥1000 copies/ml) (aOR, 1.66; 95% CI, 1.66-2.38) during the peripartum period. Preterm birth was associated with low-level viraemia (aOR, 1.44; 95% CI, 1.16-1.79) and a CD4 count of less than 200 cells/mm3 (aOR, 1.35; 95% CI, 1.01-1.82). Very preterm birth was associated with detectable maternal viraemia.
Conclusion: Adverse birth outcomes are common among pregnant women living with HIV, especially those with unsuppressed viraemia. Clinicians and programme managers should prioritise timeous ART initiation and virological suppression in all pregnant women living with HIV.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Siqithi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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المشرفين على المادة: 0 (Anti-HIV Agents)
تواريخ الأحداث: Date Created: 20240906 Date Completed: 20240906 Latest Revision: 20240910
رمز التحديث: 20240910
مُعرف محوري في PubMed: PMC11379262
DOI: 10.1371/journal.pone.0308374
PMID: 39240844
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0308374