title: Impact of Extended Combination Antiretroviral Therapy on the Decline of HIV Prevalence in Pregnant Women in Malawi.
abstract: Combination antiretroviral therapy has been shown to reduce HIV transmission and incident infections. In recent years, Malawi has significantly increased the number of individuals on combination antiretroviral drugs through more inclusive treatment policies. Using a retrospective observational cohort design, records with HIV test results were reviewed for pregnant women attending a referral hospital in Malawi over a 5-year period, with viral load measurements recorded. HIV prevalence over time was determined, and results correlated with population viral load. A total of 11 052 women were included in this analysis, with 440 (4.1%) HIV infections identified. HIV prevalence rates in pregnant women in Malawi halved from 6.4% to 3.0% over 5 years. Mean viral loads of adult patients decreased from 120 000 copies/mL to less than 20 000 copies/mL. Results suggest that community viral load has an effect on HIV incidence rates in the population, which in turn correlates with reduced HIV prevalence rates in pregnant women.
authors.affiliation: Department of Biomedicine and Prevention, Università Tor Vergata, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liotta
authors.affiliation: HIV/AIDS Department, Malawi Ministry of Health, Lilongwe, Malawi.
authors.forename: Frank
authors.initials: F
authors.lastname: Chimbwandira
authors.affiliation: HIV/STD Division, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.affiliation: Department of Pediatrics, David Geffen UCLA School of Medicine, Los Angeles, CA, USA knielsen@mednet.ucla.edu.
authors.forename: Karin
authors.initials: K
authors.lastname: Nielsen-Saines
authors.affiliation: DREAM Program Malawi, Blantyre, Malawi.
authors.forename: Haswell
authors.initials: H
authors.lastname: Jere
authors.affiliation: Department of Biomedicine and Prevention, Università Tor Vergata, Rome, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Mancinelli
authors.affiliation: DREAM Program, Community of Sant'Egidio, Rome, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Ceffa
authors.affiliation: DREAM Program, Community of Sant'Egidio, Rome, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Erba
authors.affiliation: Department of Biomedicine and Prevention, Università Tor Vergata, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Palombi
authors.affiliation: Department of Preventive Medicine, LUMSA University, Rome, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Marazzi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology*; D037841:Pregnant People; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D019380:Anti-HIV Agents
keywords: HIV prevalence; Malawi; combination antiretroviral therapy; pregnant women