Retention and viral suppression of newly diagnosed and known HIV positive pregnant women on Option B plus in Western Kenya
Retention and viral suppression of newly diagnosed and known HIV positive pregnant women on Option B plus in Western Kenya
复制标题
DOI：
10.1080/09540121.2018.1524565
复制
发表时间：
2019-03-04
影响因子：
1.7
通讯作者：
Abuogi, Lisa L.
中科院分区：
文献类型：
--
作者：
Akama, Eliud;Nimz, Abigail;Abuogi, Lisa L.
肯尼亚于2014年对感染艾滋病毒的孕妇和哺乳期妇女实施了普遍抗逆转录病毒治疗（备选方案B+）。进行了一项回顾性研究，以审查在肯尼亚西部五个诊所进行产前保健（ANC）的艾滋病毒阳性孕妇的连续记录。已知阳性妇女（KP：当前怀孕前的艾滋病毒诊断）与新阳性妇女（NP）在病毒学抑制和保留护理方面进行了比较。在纳入的165名女性中，71名（43%）NP和94名（57%）KP， NP比KP年轻(24.5岁（SD 4.6）比28.1岁（SD 5.6） （p < 0.001）。几乎所有NP患者（97%）开始接受B+方案治疗，而超过一半KP患者（59%）根据临床/免疫学标准开始接受抗逆转录病毒治疗（p < 0.0001）。KPs比NPs更有可能按照肯尼亚指南进行VL （64% vs 31%; p < 0.001）。在测试中，两组的病毒学抑制都很高（92% KP vs 100% NP; p = 0.31）。在15-18个月的随访中，KPs（82%）比NPs（66%）在护理中保持活跃（p = 0.02）。怀孕期间新诊断为艾滋病毒的妇女与怀孕前诊断的妇女相比，对VL检测的接受程度较低，在护理中的保留情况也较差。
Kenya introduced universal antiretroviral treatment (ART) for pregnant and breastfeeding women living with HIV (Option B+) in 2014. A retrospective study was conducted to review consecutive records for HIV positive pregnant women presenting for antenatal care (ANC) at five clinics in western Kenya. Known positive women (KP :HIV diagnosis prior to current pregnancy) were compared to newly positive (NP) women regarding virologic suppression and retention in care. Among 165 women included, 71 (43%) NP and 94 (57%) KP, NP were younger (24.5 years (SD 4.6) vs. 28.1 years (SD 5.6) compared to KP (p < .001). Almost all NP (97%) were initiated on Option B+ while over half of KP (59%) started ART for clinical/immunological criteria (p < .0001). KPs were more likely than NPs to have a VL performed following Kenyan guidelines (64% vs. 31%; p < .001). Among those tested, virologic suppression was high in both groups (92% KP vs. 100% NP; p = .31). More KPs (82%) vs. NPs (66%) remained active in care at 15-18 months of follow-up (p = .02). Women newly diagnosed with HIV during pregnancy show poorer uptake of VL testing and worse retention in care than those diagnosed prior to pregnancy.