title: Factors associated with viral load suppression in HIV-infected pregnant women in Rio de Janeiro, Brazil.
abstract: Viral load (VL) near delivery is a determinant of mother-to-child transmission (MTCT) of HIV. To evaluate factors associated with an undetectable VL near delivery in HIV-infected pregnant women receiving highly active antiretroviral therapy (HAART) and non-HAART regimens, HIV-infected pregnant women with a detectable VL at entry and having used antiretrovirals for ≥4 weeks before delivery were selected. Multivariate analysis was employed using binary logistic unconditional models; the dependent variable was having a VL <400 copies/mL near delivery. VL suppression was achieved in 403/707 women (57%): 65.4% in the HAART group, but only 26% in the non-HAART group P = 0.001. Duration of HAART was correlated with VL suppression, with maximum benefit seen after ≥12 weeks of therapy (odds ratio [OR]: 2.51; 95% confidence interval [CI]: 1.72-3.65). CD4+ cell count near delivery (OR: 1.53; 95% CI: 1.06-2.20) and baseline VL (OR: 0.74; 95% CI: 0.58-0.94) were also independently associated with VL suppression. Overall MTCT rate was 1.6%. HAART for ≥12 weeks, baseline VL and CD4 cell count near delivery were independently associated with viral suppression near delivery.
authors.affiliation: Department of Infectious Diseases, Hospital dos Servidores do Estado, Rio de Janeiro, Brazil. esau@uninet.com.br
authors.forename: E C
authors.initials: EC
authors.lastname: Joao
authors.forename: M I
authors.initials: MI
authors.lastname: Gouvêa
authors.forename: J A
authors.initials: JA
authors.lastname: Menezes
authors.forename: L C
authors.initials: LC
authors.lastname: Sidi
authors.forename: M L S
authors.initials: ML
authors.lastname: Cruz
authors.forename: P T
authors.initials: PT
authors.lastname: Berardo
authors.forename: L
authors.initials: L
authors.lastname: Ceci
authors.forename: C A
authors.initials: CA
authors.lastname: Cardoso
authors.forename: M de L B
authors.initials: Mde L
authors.lastname: Teixeira
authors.forename: G A
authors.initials: GA
authors.lastname: Calvet
authors.forename: H J
authors.initials: HJ
authors.lastname: Matos
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology*; D012189:Retrospective Studies; D013997:Time Factors; D019562:Viral Load / Q000187:drug effects*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents