HealthDay News — Among female patients who initiate highly-active antiretroviral therapy during pregnancy, 13.1% have detectable viral load at delivery, results of a study published in the Annals of Internal Medicine indicate.
“A high delivery maternal plasma HIV-1 RNA level (viral load [VL]) is a risk factor for mother-to-child transmission and poor maternal health,” noted Ingrid T. Katz, M.D., from Brigham and Women’s Hospital in Boston, and colleagues.
To identify factors associated with detectable VL at delivery despite initiation of highly active antiretroviral therapy (HAART) during pregnancy, the investigators conducted a multicenter observational study among 67 United States AIDS clinical research sites. The study authors measured descriptive summaries and associations among sociodemographic, HIV disease, and treatment characteristics; pregnancy-related risk factors; and detectable VL (>400 copies/mL at delivery).
Of the women in the study, 13.1% had detectable VL at delivery. Multiparity (P=0.002); black ethnicity (versus Hispanic or white; P<0.001); 11th grade education or less (P=0.013); HAART initiation in the third trimester (P=0.003); having an HIV diagnosis before the current pregnancy (P=0.051); and having the first prenatal visit in the third trimester (P=0.002) were associated with detectable VL. Having detectable VL at delivery was more likely among woman who had treatment interruptions or reported poor medication adherence.
“Social factors, including ethnicity and education, may help identify women who could benefit from focused efforts to promote early HAART initiation and adherence,” concluded the researchers.