Effect of postpartum HIV treatment discontinuation on long-term maternal outcome.
BACKGROUND
Long-term maternal outcomes after postpartum antiretroviral therapy (ART) discontinuation are unknown.


METHODS
Retrospective review of pregnancies in HIV-infected women on treatment between 1997 and 2005. Women were grouped by postpartum ART use and followed until new opportunistic infection (OI), death or last clinic visit.


RESULTS
Of 172 pregnancies, postpartum ART discontinuation occurred in 123 (71.5%) women and was associated with greater parity, no partner during pregnancy, and no indication for OI prophylaxis or preconception ART in multivariate analysis (P < .05). Median follow-up was 32.5 months after delivery. There were 12 OIs and 2 deaths; 10 OIs and both deaths occurred in women who had discontinued ART.


CONCLUSIONS
Postpartum ART discontinuation is common, especially among those with less advanced HIV disease, but may leave women at increased risk of long term adverse outcomes. This study highlights the need for larger longitudinal studies to determine appropriate recommendations for postpartum ART administration.
Onen
Nur F
NF
Washington University School of Medicine, St. Louis, Missouri, USA. nonen@im.wustl.edu
Nurutdinova
Diana
D
Sungkanuparph
Somnuek
S
Gase
Debra
D
Mondy
Kristin
K
Overton
E Turner
ET
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality / Q000635:transmission / Q000821:virology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology; D011256:Pregnancy Outcome; D016896:Treatment Outcome
D019380:Anti-HIV Agents