Socially disadvantaged pregnant women with HIV who initiate HAART (highly active antiretroviral treatment) for the first time during pregnancy face a greater risk for having detectable virus at delivery, according to a study published in Annals of Internal Medicine.
Having a high viral load at delivery puts women at risk for poor health and their infants at risk for infection. HAART has been shown to reduce viral load and is widely used in the United States, yet some women still have detectable virus at delivery. Using data from the International Maternal, Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) Group Protocol 1025 study, researchers sought to identify factors associated with having detectable virus at delivery. Of the 671 women included in the study, all of whom initiated HAART for the first time during pregnancy, 13.1 percent had detectable virus at delivery.
Those women were more likely than those with undetectable virus to be black, have a low education level, have initiated HAART and/or prenatal care in the third trimester, and have poor HAART adherence. The authors suggest that interventions for this population should promote early prenatal care, early HAART initiation, and medication adherence.
Study: Factors Associated With Lack of Viral Suppression at Delivery Among Highly Active Antiretroviral Therapy-Naive Women With HIV: A Cohort Study, I.T. Katz, E. Leister, D. Kacanek, M.D. Hughes, A. Bardeguez, E. Livingston, A. Stek, D.E. Shapiro, and R. Tuomala, Annals of Internal Medicine, doi: 10.7326/M13-2005, published 19 January 2015.