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Postpartum changes in plasma viral load and CD4 percentage among HIV-infected women from Latin American and Caribbean countries: the NISDI Perinatal Study
Melo, Victor H; Pinto, Jorge A; Freimanis-Hance, Laura; Gutierrez, Cesar; Peixoto, Mário; Santos, Breno; Machado, Daisy M; Joao, Esaú C; Robergeau, Kathleen; Read, Jennifer S.
  • Melo, Victor H; Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte. BR
  • Pinto, Jorge A; Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte. BR
  • Freimanis-Hance, Laura; Westat. Rockville. US
  • Gutierrez, Cesar; Universidad Nacional Mayor de San Marcos. Lima. PE
  • Peixoto, Mário; Hospital Femina. Porto Alegre. BR
  • Santos, Breno; Hospital Conceição. Porto Alegre. BR
  • Machado, Daisy M; Universidade Federal de São Paulo. São Paulo. BR
  • Joao, Esaú C; Hospital dos Servidores do Estado. Rio de Janeiro. BR
  • Robergeau, Kathleen; Westat. Rockville. US
  • Read, Jennifer S; National Institute of Health. Human Development. Department of Health and Human Services. National Institute of Child Health. Bethesda. US
Mem. Inst. Oswaldo Cruz ; 106(1): 97-104, Feb. 2011. tab
Article in English | LILACS | ID: lil-578824
ABSTRACT
The goal of this study was to evaluate changes in plasma human immunodeficiency virus (HIV) RNA concentration [viral load (VL)] and CD4+ percentage (CD4 percent) during 6-12 weeks postpartum (PP) among HIV-infected women and to assess differences according to the reason for receipt of antiretrovirals (ARVs) during pregnancy [prophylaxis (PR) vs. treatment (TR)]. Data from a prospective cohort of HIV-infected pregnant women (National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study) were analyzed. Women experiencing their first pregnancy who received ARVs for PR (started during pregnancy, stopped PP) or for TR (initiated prior to pregnancy and/or continued PP) were included and were followed PP. Increases in plasma VL (> 0.5 log10) and decreases in CD4 percent (> 20 percent relative decrease in CD4 percent) between hospital discharge (HD) and PP were assessed. Of the 1,229 women enrolled, 1,119 met the inclusion criteria (PR 601; TR 518). At enrollment, 87 percent were asymptomatic. The median CD4 percent values were HD [34 percent (PR); 25 percent (TR)] and PP [29 percent (PR); 24 percent (TR)]. The VL increases were 60 percent (PR) and 19 percent (TR) (p < 0.0001). The CD4 percent decreases were 36 percent (PR) and 18 percent (TR) (p < 0.0001). Women receiving PR were more likely to exhibit an increase in VL [adjusted odds ratio (AOR) 7.7 (95 percent CI 5.5-10.9) and a CD4 percent decrease (AOR 2.3; 95 percent CI 1.6-3.2). Women receiving PR are more likely to have VL increases and CD4 percent decreases compared to those receiving TR. The clinical implications of these VL and CD4 percent changes remain to be explored.
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Full text: Available Index: LILACS (Americas) Main subject: Pregnancy Complications, Infectious / HIV Infections / Viral Load / Anti-Retroviral Agents Type of study: Etiology study / Incidence study / Observational study / Risk factors Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Mem. Inst. Oswaldo Cruz Journal subject: Tropical Medicine / Parasitology Year: 2011 Type: Article / Project document Affiliation country: Brazil / Peru / United States Institution/Affiliation country: Hospital Conceição/BR / Hospital Femina/BR / Hospital dos Servidores do Estado/BR / National Institute of Health/US / Universidad Nacional Mayor de San Marcos/PE / Universidade Federal de Minas Gerais/BR / Universidade Federal de São Paulo/BR / Westat/US

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Full text: Available Index: LILACS (Americas) Main subject: Pregnancy Complications, Infectious / HIV Infections / Viral Load / Anti-Retroviral Agents Type of study: Etiology study / Incidence study / Observational study / Risk factors Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Mem. Inst. Oswaldo Cruz Journal subject: Tropical Medicine / Parasitology Year: 2011 Type: Article / Project document Affiliation country: Brazil / Peru / United States Institution/Affiliation country: Hospital Conceição/BR / Hospital Femina/BR / Hospital dos Servidores do Estado/BR / National Institute of Health/US / Universidad Nacional Mayor de San Marcos/PE / Universidade Federal de Minas Gerais/BR / Universidade Federal de São Paulo/BR / Westat/US