HIV disease progression in the first year after delivery among african women followed in the HPTN 046 clinical trial.
Watts, D. Heather.
Brown, Elizabeth R.
Coovadia, Hoosen Mahomed.
Fowler, Mary Glenn.
MetadataShow full item record
Background: Starting lifelong antiretroviral therapy (ART) in HIV-infected pregnant women may decrease HIV progression and transmission, but adherence after delivery may be difficult, especially for asymptomatic women. We evaluated disease progression among HIV-infected women not on ART with CD4⁺ lymphocyte counts above 200 cells per microliter at delivery. Methods: We analyzed risk of death, progression to AIDS (stage IV or CD4 < 200 cells per microliter), or to CD4⁺ count <350 1 year after delivery among postpartum women enrolled to a prevention of breastfeeding transmission trial using the Kaplan–Meier method. In the primary analysis, women were censored if ART was initiated. Results: Among 1285 women who were not WHO stage IV or less at 6 weeks postpartum, 49 (4.3%) progressed to stage IV/CD4 <200 cells per microliter or death by 1 year. Progression to CD4 <200 cells per microliter or death occurred among 16 (4.3%) of 441 women with CD4 count of 350–549 cells per microliter and 10 (1.6%) of 713 with CD4 counts >550 cells per microliter at delivery. CD4 <350 cells per microliter by 12 months postpartum occurred among 116 (37.0%) of 350 women with CD4 count 400–549 cells per microliter and 48 (7.4%) of 713 with CD4 count >550 cells per microliter at delivery. Conclusions: Progression to AIDS or CD4 count <350 cells per microliter is uncommon through 1 year postpartum for women with CD4 counts over 550 cells per microliter at delivery, but occurred in over one third of those with CD4 counts under 550 cells per microliter. ART should be continued after delivery or breastfeeding among women with CD4 counts <550 cells per microliter if follow-up and antiretroviral adherence can be maintained.
Showing items related by title, author, creator and subject.
Visser, Dael Desiree. (2007)Soybeans, Glycine max, are an economically and strategically important crop in South Africa (SA). In order to meet local demands, large imports of soybeans are required, e.g., in the 2005/2006 soybean production period, ...
Characterization of potato virus Y (PVY) isolates infecting solanaceous vegetables in KwaZulu-Natal (KZN), Republic of South Africa (RSA) Ibaba, Jacques Davy. (2009)Potato virus Y (PVY) is an economically important virus worldwide. In South Africa, PVY has been shown to be a major limiting factor in the production of important solanaceous crops, including potato (Solanum tuberosum ...
Studies on the use of biocontrol agents and soluble silicon against powdery mildew of zucchini and zinnia. Tesfagiorgis, Habtom Butsuamlak. (2008)Powdery mildew (PM) is an important foliar disease of many crops, occurring under both greenhouse and field conditions. The application of biological control and soluble silicon (Si) against PM has received increasing ...