Impact of antiretroviral regimen on viral suppression among pregnant women living with HIV in Brazil
| Autor: | Gerson Fernando Mendes Pereira, Filipe de Barros Perini, Fernanda Fernandes Fonseca, Rosana Gonçalves Gonçalves Pinho, Vivian Iida Avelino-Silva, Ana Roberta Pati Pascom |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Cyclopropanes Mother to child transmission Atazanavir Sulfate Human immunodeficiency virus (HIV) HIV Infections Dermatology 030312 virology medicine.disease_cause 03 medical and health sciences 0302 clinical medicine immune system diseases Pregnancy Antiretroviral Therapy Highly Active Raltegravir Potassium medicine Humans Pharmacology (medical) 030212 general & internal medicine Viral suppression Pregnancy Complications Infectious 0303 health sciences business.industry Transmission (medicine) Public Health Environmental and Occupational Health virus diseases Middle Aged Viral Load medicine.disease Virology Antiretroviral therapy Infectious Disease Transmission Vertical Benzoxazines Regimen Infectious Diseases Treatment Outcome Alkynes HIV-1 Female business Viral load Brazil |
| Zdroj: | International journal of STDAIDS. 31(9) |
| ISSN: | 1758-1052 |
| Popis: | Human immunodeficiency virus (HIV) viral load (VL) during pregnancy is a critical determinant of the risk of HIV mother-to-child transmission (MTCT). Prior studies suggest that VL suppression is influenced by antiretroviral regimen. In this study, using secondary real-life data from the Ministry of Health of Brazil, we compared VL suppression at 60–180 days after the first antiretroviral therapy (ART) prescription during pregnancy and time to undetectable VL among pregnant women under treatment with double nucleoside/nucleotide regimens combined with efavirenz, boosted lopinavir, boosted atazanavir, or raltegravir, with adjustment for potential confounders in multivariable models. A total of 18,997 pregnant women living with HIV were included in the study. Compared to regimens containing lopinavir, we found that atazanavir-, efavirenz-, and raltegravir-based regimens were superior in achieving both outcomes after adjustment for age, social vulnerability index, time under ART, baseline CD4+ cell count, and baseline HIV VL. Raltegravir-containing regimens had the highest adjusted odds/rates of VL suppression compared to patients with other regimens. Elimination of HIV MTCT is still a critical public health issue in many countries. Our findings suggest that raltegravir-based regimens were superior when compared to efavirenz-, lopinavir-, and atazanavir-based antiretroviral regimens in achieving suppression of HIV VL. |
| Databáze: | OpenAIRE |
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