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

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-infect...

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Autores principales: Denoeud-Ndam, Lise, Fourcade, Camille, Ogouyemi-Hounto, Aurore, Azon-Kouanou, Angèle, d'Almeida, Marcelline, Azondékon, Alain, Alao, Marouf J., Dossou-Gbété, Véronique, Afangnihoun, Aldric, Girard, Pierre-Marie, Cot, Michel, Zannou, Djimon-Marcel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598754/
https://www.ncbi.nlm.nih.gov/pubmed/23555035
http://dx.doi.org/10.1371/journal.pone.0059446
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author Denoeud-Ndam, Lise
Fourcade, Camille
Ogouyemi-Hounto, Aurore
Azon-Kouanou, Angèle
d'Almeida, Marcelline
Azondékon, Alain
Alao, Marouf J.
Dossou-Gbété, Véronique
Afangnihoun, Aldric
Girard, Pierre-Marie
Cot, Michel
Zannou, Djimon-Marcel
author_facet Denoeud-Ndam, Lise
Fourcade, Camille
Ogouyemi-Hounto, Aurore
Azon-Kouanou, Angèle
d'Almeida, Marcelline
Azondékon, Alain
Alao, Marouf J.
Dossou-Gbété, Véronique
Afangnihoun, Aldric
Girard, Pierre-Marie
Cot, Michel
Zannou, Djimon-Marcel
author_sort Denoeud-Ndam, Lise
collection PubMed
description 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. Socio-economic 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.
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spelling pubmed-35987542013-04-02 Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin Denoeud-Ndam, Lise Fourcade, Camille Ogouyemi-Hounto, Aurore Azon-Kouanou, Angèle d'Almeida, Marcelline Azondékon, Alain Alao, Marouf J. Dossou-Gbété, Véronique Afangnihoun, Aldric Girard, Pierre-Marie Cot, Michel Zannou, Djimon-Marcel PLoS One Research Article 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. Socio-economic 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. Public Library of Science 2013-03-15 /pmc/articles/PMC3598754/ /pubmed/23555035 http://dx.doi.org/10.1371/journal.pone.0059446 Text en © 2013 Denoeud-Ndam et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Denoeud-Ndam, Lise
Fourcade, Camille
Ogouyemi-Hounto, Aurore
Azon-Kouanou, Angèle
d'Almeida, Marcelline
Azondékon, Alain
Alao, Marouf J.
Dossou-Gbété, Véronique
Afangnihoun, Aldric
Girard, Pierre-Marie
Cot, Michel
Zannou, Djimon-Marcel
Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
title Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
title_full Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
title_fullStr Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
title_full_unstemmed Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
title_short Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin
title_sort predictive factors of plasma hiv suppression during pregnancy: a prospective cohort study in benin
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598754/
https://www.ncbi.nlm.nih.gov/pubmed/23555035
http://dx.doi.org/10.1371/journal.pone.0059446
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