dc.contributor.author |
Moyo, Faith
|
|
dc.contributor.author |
Mazanderani, Ahmad Haeri
|
|
dc.contributor.author |
Murray, Tanya
|
|
dc.contributor.author |
Technau, Karl-G.
|
|
dc.contributor.author |
Carmona, Sergio
|
|
dc.contributor.author |
Kufa, Tendesayi
|
|
dc.contributor.author |
Sherman, Gayle G.
|
|
dc.date.accessioned |
2021-02-02T15:27:36Z |
|
dc.date.issued |
2020-04-01 |
|
dc.description.abstract |
BACKGROUND : Elimination of mother-to-child transmission of HIV
requires sustained viral load suppression during pregnancy and
breastfeeding among women living with HIV (WLHIV). Antenatal
antiretroviral therapy coverage is reported at .95% in South Africa,
but viral load suppression rates are unknown. We describe maternal
VL burden around time of delivery at 4 tertiary obstetric units
(TOUs) in Gauteng Province.
METHODS : Between June 2018 and March 2019, routine point-ofcare
(PoC) maternal HIV VL and early infant diagnosis (EID) testing
were implemented at 3 TOUs in Johannesburg and 1 in Tshwane
district. WLHIV and HIV-exposed neonates were eligible for HIV
VL (Xpert HIV-1 VL) and EID (Xpert HIV-1 EID or m-PIMA
HIV1/2 detection) testing around time of delivery, respectively.
Proportions of viremic women and intrauterine (IU)-infected neonates
were calculated among valid PoC results.
RESULTS : Among 8147 live births to WLHIV, 2769 (34.0%) women
and 4333 (53.2%) neonates had valid PoC results. Median VL at
delivery was ,40 copies/mL (interquartile range: 0–398). The
proportion of women with a VL , 50, 50 to ,1000, and $1000
copies/mL was 63.6%, 13.9% and 22.4%, respectively. There were
65/4333 (1.5%) IU-infected neonates. Among 1449 mother–neonate
pairs with both VL and EID results, IU transmission by VL threshold
was 3/946 (0.3%), 6/187 (3.2%), and 25/316 (7.9%) for VL , 50, 50
to ,1000, and $1000 copies/mL, respectively (P , 0.001).
CONCLUSIONS : Despite high antiretroviral therapy coverage, .1/3
of WLHIV had a VL $50 copies/mL at delivery. Among
mother–neonate pairs, maternal VL $50 copies/mL accounted for
31/34 (91%) IU infections. Improvement in the quality of HIV care
among WLHIV is essential if South Africa is to achieve elimination
of mother-to-child transmission. |
en_ZA |
dc.description.department |
Medical Virology |
en_ZA |
dc.description.embargo |
2021-04-01 |
|
dc.description.librarian |
am2020 |
en_ZA |
dc.description.sponsorship |
The Clinton Health Access Initiative |
en_ZA |
dc.description.uri |
http://journals.lww.com/jaids |
en_ZA |
dc.identifier.citation |
Moyo, F., Mazanderani, A.H., Murray, T. et al. 2020, 'Characterizing viral load burden among HIV-infected women around the time of delivery : findings from four tertiary obstetric units in Gauteng, South Africa', Journal of Acquired Immune Deficiency Syndromes, vol. 83, no. 4, pp. 390-396. |
en_ZA |
dc.identifier.issn |
1525-4135 (print) |
|
dc.identifier.issn |
1944-7884 (online) |
|
dc.identifier.other |
10.1097/QAI.0000000000002267 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/78201 |
|
dc.language.iso |
en |
en_ZA |
dc.publisher |
Lippincott Williams and Wilkins |
en_ZA |
dc.rights |
© 2020 Wolters Kluwer Health / Lippincott Williams & Wilkins. This is a non-final version of an article published in final form in Journal of Acquired Immune Deficiency Syndromes, vol. 83, no. 4, pp. 390-396, 2020. doi : 10.1097/QAI.0000000000002267. |
en_ZA |
dc.subject |
Viral load suppression |
en_ZA |
dc.subject |
Intrauterine transmission |
en_ZA |
dc.subject |
Point-of-care |
en_ZA |
dc.subject |
Pregnancy |
en_ZA |
dc.subject |
Mother-to-child transmission (MTCT) |
en_ZA |
dc.subject |
Human immunodeficiency virus (HIV) |
en_ZA |
dc.subject |
Women living with HIV (WLHIV) |
en_ZA |
dc.subject |
Tertiary obstetric unit (TOU) |
en_ZA |
dc.subject |
Early infant diagnosis (EID) |
en_ZA |
dc.title |
Characterizing viral load burden among HIV-infected women around the time of delivery : findings from four tertiary obstetric units in Gauteng, South Africa |
en_ZA |
dc.type |
Postprint Article |
en_ZA |