Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin

Abstract : Objective: To investigate the factors associated with HIV 1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin. Design: Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. Methods: HIV-infected women were enrolled in the second trimester of pregnancy. Socioeconomic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART) for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. Results: Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area), regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. Conclusions: This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control.
Type de document :
Article dans une revue
PLoS ONE, Public Library of Science, 2013, 8 (3), pp.e59446. 〈10.1371/journal.pone.0059446〉
Liste complète des métadonnées

Littérature citée [34 références]  Voir  Masquer  Télécharger

http://hal.upmc.fr/hal-01618830
Contributeur : Gestionnaire Hal-Upmc <>
Soumis le : mercredi 18 octobre 2017 - 15:27:35
Dernière modification le : vendredi 20 octobre 2017 - 01:14:00

Fichier

journal.pone.0059446.PDF
Publication financée par une institution

Licence


Distributed under a Creative Commons Paternité 4.0 International License

Identifiants

Collections

Citation

Lise Denoeud-Ndam, Camille Fourcade, Aurore Ogouyemi-Hounto, Angèle Azon-Kouanou, Marcelline D 'Almeida, et al.. Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin. PLoS ONE, Public Library of Science, 2013, 8 (3), pp.e59446. 〈10.1371/journal.pone.0059446〉. 〈hal-01618830〉

Partager

Métriques

Consultations de la notice

48

Téléchargements de fichiers

11