Postpartum changes in plasma viral load and CD4 percentage among HIV-infected women from Latin American and Caribbean countries: the NISDI Perinatal Study

Postpartum changes in plasma viral load and CD4 percentage among HIV-infected women from Latin American and Caribbean countries: the NISDI Perinatal Study

Autor Melo, Victor H Google Scholar
Pinto, Jorge A Google Scholar
Freimanis-Hance, Laura Google Scholar
Gutierrez, Cesar Google Scholar
Peixoto, Mário Google Scholar
Santos, Breno Google Scholar
Machado, Daisy Maria Autor UNIFESP Google Scholar
Joao, Esaú C Google Scholar
Robergeau, Kathleen Google Scholar
Read, Jennifer S Google Scholar
Instituição Universidade Federal de Minas Gerais Faculdade de Medicina
Westat
Universidad Nacional Mayor de San Marcos
Hospital Femina
Hospital Conceição
Universidade Federal de São Paulo (UNIFESP)
Hospital dos Servidores do Estado
National Institute of Health Human Development Department of Health and Human Services
Resumo The goal of this study was to evaluate changes in plasma human immunodeficiency virus (HIV) RNA concentration [viral load (VL)] and CD4+ percentage (CD4%) 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% (> 20% relative decrease in CD4%) 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% were asymptomatic. The median CD4% values were: HD [34% (PR); 25% (TR)] and PP [29% (PR); 24% (TR)]. The VL increases were 60% (PR) and 19% (TR) (p < 0.0001). The CD4% decreases were 36% (PR) and 18% (TR) (p < 0.0001). Women receiving PR were more likely to exhibit an increase in VL [adjusted odds ratio (AOR) 7.7 (95% CI: 5.5-10.9) and a CD4% decrease (AOR 2.3; 95% CI: 1.6-3.2). Women receiving PR are more likely to have VL increases and CD4% decreases compared to those receiving TR. The clinical implications of these VL and CD4% changes remain to be explored.
Palavra-chave HIV
pregnancy
postpartum period
viral load
CD4 counts
Idioma Inglês
Data de publicação 2011-02-01
Publicado em Memórias do Instituto Oswaldo Cruz. Instituto Oswaldo Cruz, Ministério da Saúde, v. 106, n. 1, p. 97-104, 2011.
ISSN 0074-0276 (Sherpa/Romeo, fator de impacto)
Publicador Instituto Oswaldo Cruz, Ministério da Saúde
Extensão 97-104
Fonte http://dx.doi.org/10.1590/S0074-02762011000100016
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000287712000016
SciELO S0074-02762011000100016 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/6296

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