Correlates of HIV detection among breastfeeding postpartum Kenyan women eligible under Option B+
| العنوان: | Correlates of HIV detection among breastfeeding postpartum Kenyan women eligible under Option B+ |
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| المؤلفون: | Vrasha Chohan, Julie Overbaugh, Bhavna Chohan, Anna Wald, Lisa M. Frenkel, Eric Munene Muriuki, Ruth Kanthula, Sandra Emery, Mary Chan, Alison C. Roxby |
| المصدر: | PLoS ONE PLoS ONE, Vol 14, Iss 5, p e0216252 (2019) |
| بيانات النشر: | Public Library of Science, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, RNA viruses, Physiology, Maternal Health, Breastfeeding, HIV Infections, Logistic regression, Pathology and Laboratory Medicine, Pediatrics, Families, 0302 clinical medicine, Immunodeficiency Viruses, Pregnancy, Risk Factors, Medicine and Health Sciences, Public and Occupational Health, 030212 general & internal medicine, Breast Milk, Children, Multidisciplinary, Obstetrics, Postpartum Period, Obstetrics and Gynecology, Viral Load, Vaccination and Immunization, 3. Good health, Body Fluids, Milk, Breast Feeding, Anti-Retroviral Agents, Medical Microbiology, Viral Pathogens, Cohort, Viruses, Medicine, Gestation, RNA, Viral, Female, Pathogens, Anatomy, Infants, Research Article, Adult, medicine.medical_specialty, Science, Immunology, Antiretroviral Therapy, Breast milk, Microbiology, Beverages, 03 medical and health sciences, Antiviral Therapy, Virology, Retroviruses, medicine, Humans, Microbial Pathogens, Secretion, Nutrition, Retrospective Studies, business.industry, Lentivirus, Organisms, Biology and Life Sciences, HIV, medicine.disease, 030112 virology, Kenya, Diet, Regimen, Age Groups, People and Places, HIV-1, Women's Health, Population Groupings, Preventive Medicine, Neonatology, business, Physiological Processes, Postpartum period, Viral Transmission and Infection |
| الوصف: | BackgroundThe Option B+ strategy streamlines delivery of HIV antiretroviral therapy (ART) to pregnant women, but concerns remain about ART treatment adherence and long term outcomes.MethodsWe conducted a retrospective analysis of a cohort of HIV-positive, postpartum breastfeeding women receiving ART via Option B+ in Nairobi, Kenya. The primary outcome was virologic failure in plasma (HIV RNA >1000 copies/mL), and detection in breast milk (>150 copies/mL) and endocervical secretions (>100 copies/mL) at 2 postpartum timepoints. Correlates of virologic failure were assessed using univariate tests and multivariate logistic regression.ResultsOf 42 women at 6-14 weeks postpartum, 21.4% of women had HIV RNA detected in plasma; 14.3% in breast milk, and 23.7% in endocervical secretions. At 18-24 weeks postpartum, the percentages were 21.1%, 7.1%, and 14.3%, respectively. Younger maternal age, intent to breastfeed for longer, and later ART start in pregnancy were significantly associated with plasma virologic failure (p < 0.05 for each). Odds of plasma virologic failure at 6-14 weeks postpartum were 1.25 times higher (95% CI 1.04, 1.51) for each increase in week of gestation at ART initiation. Only 3 women had resistance mutations to their regimen.ConclusionsDespite months of ART, nearly one-quarter of the women in our cohort did not achieve plasma virologic suppression in the postpartum period. After adjusting for time on ART, earlier ART initiation in pregnancy was significantly associated with plasma suppression. Our findings suggest that postpartum HIV RNA monitoring in Option B+ programs will be needed to achieve elimination of MTCT. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1b8d033c8026aa62117a2e866deff720 http://europepmc.org/articles/PMC6544340 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....1b8d033c8026aa62117a2e866deff720 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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