NDLI: Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in Johannesburg, South Africa.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hoffman, Risa M. Black, Vivian Technau, Karl Van Der Merwe, Karin Joan Currier, Judith Coovadia, Ashraf Chersich, Matthew
Spatial Coverage	South Africa
Description	Country affiliation: United States Author Affiliation: Hoffman RM ( David Geffen School of Medicine at UCLA, Division of Infectious Diseases and Center for Clinical AIDS Research and Education, Los Angeles, CA, USA. rhoffman@mednet.ucla.edu)
Abstract	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.
File Format	HTM / HTML
ISSN	15254135
e-ISSN	10779450
DOI	10.1097/QAI.0b013e3181cf9979
Journal	JAIDS Journal of Acquired Immune Deficiency Syndromes
Issue Number	1
Volume Number	54
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline AIDS Antiretroviral Therapy, Highly Active Hiv Infections Drug Therapy Transmission Infectious Disease Transmission, Vertical Prevention & Control Pregnancy Complications, Infectious Infant Infant, Newborn Pregnancy Rna, Viral Blood Time Factors
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Pharmacology (medical)

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