Loss to follow-up before and after delivery among women testing HIV positive during pregnancy in Johannesburg, South Africa.
Loss to follow-up before and after delivery among women testing HIV positive during pregnancy in Johannesburg, South Africa.
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DOI：
10.1111/tmi.12072
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Fox MP
中科院分区：
文献类型：
--
作者：
Clouse K;Pettifor A;Shearer K;Maskew M;Bassett J;Larson B;Van Rie A;Sanne I;Fox MP
艾滋病毒抗体阳性的孕妇在艾滋病毒护理方面失去后续行动的风险更高。我们在新诊断为HIV的孕妇中检查了分娩前后的LTFU。在2010年1月至6月在南非约翰内斯堡的一家初级医疗保健诊所进行的首次ANC访视时首次检测HIV阳性的所有≥18岁（N=300）孕妇的观察性队列研究。排除了无法确定分娩日期的女性（n=27）。HIV检测时的中位妊娠期（IQR）为26周（21-30周）。98.0%接受AZT预防，通常在首次ANC访视时开始。在139例（51.3%）符合ART条件的患者中，66.9%（95%CI 58.8-74.3%）在分娩前开始ART;分娩前ART的中位（IQR）持续时间为9.5周（5.1-14.2）。在符合ART条件的患者中，40.5%（32.3-49.0%）累积保留ART治疗6个月。在HIV检测时不符合ART条件的患者中，仅22.6%（95%CI 15.9-30.6%）完成了CD 4分期，并在分娩后返回接受重复CD 4检测。分娩前的LTFU（末次计划访视延迟≥1个月）为20.5%（95%CI 16.0-25.6%），分娩后6个月内仍在接受治疗的患者中为47.9%（95%CI 41.2-54.6%）。总体而言，57.5%（95%CI 51.6-63.3%）在HIV检测和分娩后6个月之间丢失。我们的研究结果强调了接受产前服务的艾滋病毒阳性孕妇，特别是那些没有资格接受抗逆转录病毒治疗的孕妇的护理连续性的挑战。
HIV-positive pregnant women are at heightened risk of becoming lost to follow-up (LTFU) from HIV care. We examined LTFU before and after delivery among pregnant women newly-diagnosed with HIV. Observational cohort study of all pregnant women ≥18 years (N=300) testing HIV-positive for the first time at their first ANC visit between January–June 2010, at a primary healthcare clinic in Johannesburg, South Africa. Women (n=27) whose delivery date could not be determined were excluded. Median (IQR) gestation at HIV testing was 26 weeks (21–30). 98.0% received AZT prophylaxis, usually started at the first ANC visit. Of 139 (51.3%) patients who were ART-eligible, 66.9% (95%CI 58.8–74.3%) initiated ART prior to delivery; median (IQR) ART duration pre-delivery was 9.5 weeks (5.1–14.2). Among ART-eligible patients, 40.5% (32.3–49.0%) were cumulatively retained through six months on ART. Of those ART-ineligible at HIV testing, only 22.6% (95%CI 15.9–30.6%) completed CD4 staging and returned for a repeat CD4 test after delivery. LTFU (≥1 month late for last scheduled visit) before delivery was 20.5% (95%CI 16.0–25.6%) and, among those still in care, 47.9% (95%CI 41.2–54.6%) within six months after delivery. Overall, 57.5% (95%CI 51.6–63.3%) were lost between HIV testing and six months post-delivery. Our findings highlight the challenge of continuity of care among HIV-positive pregnant women attending antenatal services, particularly those ineligible for ART.
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影响因子：
3.3
作者：
Ferguson, Laura;Grant, Alison D.;Ross, David A.
通讯作者：
Ross, David A.
DOI：
10.1097/qai.0b013e318253258a
发表时间：
2012-07-01
影响因子：
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作者：
Ferguson, Laura;Lewis, James;Ross, David A.
通讯作者：
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影响因子：
11.8
作者：
Patel, Deven
通讯作者：
Patel, Deven
DOI：
10.1097/00126334-200207010-00007
发表时间：
2002-07-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Ickovics, JR;Wilson, TE;Koenig, LJ
通讯作者：
Koenig, LJ
DOI：
10.1097/qai.0b013e318229147e
发表时间：
2011-10-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Chibwesha CJ;Giganti MJ;Putta N;Chintu N;Mulindwa J;Dorton BJ;Chi BH;Stringer JS;Stringer EM
通讯作者：
Stringer EM