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Multicenter Study
. 2021 Nov 16;73(10):1750-1758.
doi: 10.1093/cid/ciab206.

Factors Associated With Peripartum Virologic Suppression in Eastern Cape Province, South Africa: A Retrospective Cross-Sectional Analysis

Oladele Vincent Adeniyi  1 , Chikwelu Larry Obi  2 , Daniel Ter Goon  3 , Benson Iweriebor  2 , Nonkosi Selanto-Chairman  3 , Craig Carty  4 , Gordana Avramovic  5 , Anthony Idowu Ajayi  6 , John Lambert  5 , Anthony Okoh  7
Affiliations
Multicenter Study

Factors Associated With Peripartum Virologic Suppression in Eastern Cape Province, South Africa: A Retrospective Cross-Sectional Analysis

Oladele Vincent Adeniyi et al. Clin Infect Dis. .

Abstract

Background: This study describes the characteristics of pregnant women on antiretroviral therapy (ART) and the rate of peripartum virologic suppression in a large prevention of mother-to-child transmission cohort who delivered in some selected maternity centers in Eastern Cape Province, South Africa. In addition, the study examines the factors associated with virologic suppression in the cohort.

Methods: This multicenter, retrospective cross-sectional analysis included medical data of 1709 women with human immunodeficiency virus between September 2015 and May 2016 in Eastern Cape Province. The main outcome measure was the rate of peripartum virologic suppression, defined as viral load (VL) <1000 copies/mL and undetectable viremia (VL <20 copies/mL). Correlates of peripartum virologic suppression and undetectable viremia were examined by fitting logistic regression model analysis.

Results: Of 1463 women with available VL results, the overall rate of peripartum suppression was 82%, and undetectable viremia was 56.9%. Being aged 24 years or younger (adjusted odds ratio [AOR], 0.68 [95% confidence interval {CI}, .48-.94]), smoking during pregnancy (AOR, 0.50 [95% CI, .28-.90]), and starting ART in the first trimester were associated with lower odds of viral suppression (<1000 copies/mL). Women who had never defaulted ART had an increased odds of having an undetectable VL (AOR, 3.09 [95% CI, 2.12-4.49]) and virologic suppression (AOR, 3.88 [95% CI, 2.62-5.74]) compared to those who defaulted.

Conclusions: More than half of the women achieved undetectable VL, and 4 in 5 women achieved viral suppression at delivery in the region. Early antenatal booking, combined with enhanced adherence support for pregnant women on ART, would be crucial toward achieving the goal of elimination of mother-to-child transmission in the region.

Keywords: HIV; South Africa; antiretroviral therapy; in utero transmission; mother-to-child transmission.

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References

    1. Joint United Nations Programme on HIV/AIDS. South Africa. 2019. Available at: https://www.unaids.org/en/regionscountries/countries/southafrica. Accessed 12 June 2020.
    1. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis. 2014. Available at: http://www.who.int/iris/handle/10665/112858. Accessed 12 June 2020.
    1. Goga AE, Dinh TH, Jackson DJ, et al. ; South Africa PMTCT Evaluation Team . First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa. J Epidemiol Community Health 2015; 69:240–8. - PMC - PubMed
    1. Goga AE, Dinh TH, Jackson DJ, et al. ; South Africa PMTCT Evaluation (SAPMCTE) Team . Population-level effectiveness of PMTCT Option A on early mother-to-child (MTCT) transmission of HIV in South Africa: implications for eliminating MTCT. J Glob Health 2016; 6:020405. - PMC - PubMed
    1. South African National Department of Health. National consolidated guideline for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescent and adults; 2015. Available at: https://aidsfree.usaid.gov/sites/default/files/tx_south-africa_pmtct_201.... Accessed 2 June 2018.

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