Denoeud Ndam Lise, Fourcade C., Ogouyemi-Hounto A., Azon-Kouanou A., d'Almeida M., Azondekon A., Alao M. J., Dossou-Gbete V., Afangnihoun A., Girard P. M., Cot Michel, Zannou D. M. (2013). Predictive factors of plasma HIV suppression during pregnancy : a prospective cohort study in Benin. Plos One, 8 (3), p. e59446. ISSN 1932-6203.
Titre du document
Predictive factors of plasma HIV suppression during pregnancy : a prospective cohort study in Benin
Année de publication
2013
Auteurs
Denoeud Ndam Lise, Fourcade C., Ogouyemi-Hounto A., Azon-Kouanou A., d'Almeida M., Azondekon A., Alao M. J., Dossou-Gbete V., Afangnihoun A., Girard P. M., Cot Michel, Zannou D. M.
Source
Plos One, 2013,
8 (3), p. e59446 ISSN 1932-6203
Objective: To investigate the factors associated with HIV1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin. Design: Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. Methods: HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART) for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. Results: Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area), regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. Conclusions: This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
BENIN
Localisation
Fonds IRD [F B010060781]
Identifiant IRD
fdi:010060781
