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HIV RNA Suppression during and after Pregnancy among Women in the HIV Outpatient Study, 1996 to 2015

Patel, Monita
; ; 
Armon, Carl
; 
Nesheim, Steven
; 
Lampe, Margaret
; 
Palella, Frank, Jr.,
; 
Novak, Richard
; 
Sutton, Madeline
; 
Buchacz, Kate
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Genre
Journal article
Date
2018-01-22
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Committee member
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Department
Medicine
Subject
HIV
 Postpartum
 Pregnancy
 Viral suppression
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http://hdl.handle.net/20.500.12613/8391
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Tedaldi-JournalArticle-2018.pdf
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DOI
https://doi.org/10.1177/2325957417752259
Abstract
Objective: To examine HIV viral suppression during/after pregnancy. Design: Prospective observational cohort. Methods: We identified pregnancies from 1996 to 2015. We examined HIV RNA viral load (VL), VL suppression (≤500 copies/mL), and antiretroviral therapy (ART) status at pregnancy start, end, and 6 months postpartum. We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for VL nonsuppression. Results: Among 253 pregnancies analyzed, 34.8% of women exhibited VL suppression at pregnancy start, 60.1% at pregnancy end, and 42.7% at 6 months postpartum. Median VL (log10 copies/mL) was 2.80 (interquartile range [IQR]: 1.40-3.85) at pregnancy start, 1.70 (IQR: 1.40-2.82) at pregnancy end, and 2.30 (IQR: 1.40-3.86) at postpartum. Risk of postpartum VL nonsuppression was also lower among women on ART and with VL suppression at pregnancy end (versus those not; adjusted RR = 0.30, 95% CI: 0.17-0.53). Conclusions: Maintaining VL suppression among US women remains a challenge, particularly during postpartum. Achieving VL suppression earlier during pregnancy benefits women subsequently.
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Citation
Patel M, Tedaldi E, Armon C, et al. HIV RNA Suppression during and after Pregnancy among Women in the HIV Outpatient Study, 1996 to 2015. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2018;17. doi:10.1177/2325957417752259
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SAGE Publications
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Journal of the International Association of Providers of AIDS Care (JIAPAC), Vol. 17
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