Health outcomes of asymptomatic HIV-infected pregnant women initiating antiretroviral therapy at different baseline CD4 counts in Ethiopia
Health outcomes of asymptomatic HIV-infected pregnant women initiating antiretroviral therapy at different baseline CD4 counts in Ethiopia
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DOI：
10.1016/j.ijid.2019.02.019
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发表时间：
2019-05-01
影响因子：
8.4
通讯作者：
Magnus, Maria
中科院分区：
文献类型：
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作者：
Ejigu, Yohannes;Magnus, Jeanette H.;Magnus, Maria
目的：比较以下的健康结果开始抗逆转录病毒治疗（ART）的无症状艾滋病毒感染的孕妇在不同的CD 4 levels.Methods：我们分析了数据从706无症状艾滋病毒感染的埃塞俄比亚妇女在怀孕期间开始ART 2012年2月和2016年10月之间。结果：平均而言，治疗12个月后，CD 4计数（cells/mm（3））从基线时的391（95% CI：372-409）增加到523（95% CI：495-551）。基线CD 4在350 - 499之间的妇女的CD 4增加率高于CD 4>= 500的妇女（207比6，p < 0.001）。但基线CD 4在350 - 499之间的女性无法赶上CD 4>= 500的女性。基线CD 4>= 500的妇女与CD 4在350和499之间的妇女相比，实现CD 4正常化的可能性显著更高（AOR = 0.32，95%CI：0.13-0.76）。结论：在资源有限的情况下，对CD 4计数>= 500 cells/mm（3）的无症状HIV感染妇女开始抗逆转录病毒治疗有利于在治疗12个月后保持或恢复免疫力。(C)2019作者（S）由Elsevier Ltd代表国际传染病学会出版。
Objective: To compare health outcomes following initiation of antiretroviral therapy (ART) for asymptomatic HIV-infected pregnant women at different CD4 levels.Methods: We analyzed data from 706 asymptomatic HIV-infected Ethiopian women initiating ART during pregnancy between February 2012 and October 2016. The outcomes evaluated were CD4 gain, CD4 normalization (CD4 count >= 750 cells/mm(3)) and occurrence of HIV-related clinical events after twelve months of treatment.Result: On average, CD4 count (cells/mm(3)) increased from 391 (95% CI: 372-409) at baseline to 523 (95% CI: 495-551) after twelve months of treatment. Rate of CD4 gain was higher among women with baseline CD4 between 350 and 499 compared to CD4 >= 500 (207 versus 6, p < 0.001). But women with baseline CD4 between 350 and 499 could not catch up with women with CD4 >= 500. Women with baseline CD4 >= 500 had significantly higher likelihood of achieving CD4 normalization as compared to those with CD4 between 350 and 499 (AOR = 0.32, 95% CI: 0.13-0.76). No strong evidence of differential risk in the occurrence of HIV-related clinical events.Conclusion: Starting ART for asymptomatic HIV-infected women with CD4 count >= 500 cells/mm(3) was beneficial to preserve or recover immunity after 12 months of treatment in a resource limited setting. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.