Characteristics associated with suboptimal viral suppression at delivery in human immunodeficiency virus-1-infected pregnant women.
OBJECTIVE
This study was undertaken to determine clinical characteristics and factors associated with suboptimal viral suppression at delivery in human immunodeficiency virus (HIV)-infected women.


METHODS
All HIV-infected women who delivered at a single urban tertiary care center from January 1999 to June 2004 were studied. Women were divided into 2 groups based on HIV viral load (VL) proximate to delivery: VL < 1000 copies per milliliter and VL > or = 1000 copies per milliliter. Demographic and clinical factors were analyzed and compared between the 2 groups.


RESULTS
A total of 146 women had adequate data available for analysis: 102 (69.9%) had VL < 1000 copies per milliliter and 44 (30.1%) had VL > or = 1000 copies per milliliter at delivery. Women with a viral load > or = 1000 copies per milliliter at delivery were more likely to have a baseline viral load VL > or = 10,000 copies per milliliter (66.7% vs 32%, P < .001) and less likely to report medication adherence, (50% vs 87.8%, P < .001).


CONCLUSIONS
Our findings support the concept that in addition to antiviral medical therapy, intervention to improve adherence and maintaining a low baseline VL are key components to VL suppression in pregnancy.
Louis
Judette M
JM
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology at Wayne State University, Detroit, MI, USA.
Buhari
Mudathiru A
MA
Blackwell
Sean C
SC
Refuerzo
Jerrie
J
Allen
Dianne
D
Gonik
Bernard
B
Jones
Theodore B
TB
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000382:microbiology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood* / Q000188:drug therapy; D019562:Viral Load
D019380:Anti-HIV Agents