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29 results for “Prevention of Mother to Child Transmission of HIV”
Data from: Implementation of Option B and a fixed-dose combination antiretroviral regimen for prevention of mother-to-child transmission of HIV in South Africa: a model of uptake and adherence to care
<p><b>Introduction</b></p> <p>Initiating and retaining pregnant women on antiretroviral therapy (ART) to prevent mother-to-child HIV transmission (PMTCT) remains a major challenge facing African HIV programs, particularly during the critical final months prior to delivery. In 2013, South Africa implemented its "Option B" PMTCT regimen (three-drug ART throughout pregnancy and breastfeeding, regardless of maternal CD4 count) and introduced once-daily fixed-dose combinations and lifelong ART. Currently, the uptake of Option B and its possible impact on adherence to PMTCT during the critical final months of pregnancy is unclear.</p> <p><b>Materials and Methods </b></p> <p>We prospectively collected visit data from a cohort of adult, HIV-infected, pregnant women between July 2013-August 2014 to estimate three models of adherence to PMTCT during the final 16 weeks immediately preceding delivery. Adherence was defined according to possession of antiretroviral drugs, which was inferred from clinic visit records under varying assumptions in each model. We describe uptake of the PMTCT regimen, gestational age at initiation, and model possible scenarios of adherence through delivery after the implementation of Option B.</p> <p><b>Results</b></p> <p>Among 138 women enrolled (median (IQR) age 28 years (24-32), median CD4 count 378 cells/mm3), median (IQR) gestational age at initiation was 22 weeks (16-26). Estimates of adherence during the final 16 weeks of pregnancy prior to delivery ranged from 75% (52-89%) under the best case scenario assumptions to 52% (30-75%) under the worst case scenario assumptions. Estimates of the proportion of women who would achieve 80% adherence to PMTCT were <50% across all models.</p> <p><b>Conclusions</b></p> <p>Despite the switch to Option B and once-daily dosing, South African women continue to initiate PMTCT late in pregnancy, and estimations of regimen adherence, as modelled using PMTCT visit attendance data, is poor, with <50% of women reaching 80% adherence during final months of pregnancy across all models. Further guideline changes and interventions are needed to achieve vertical transmission goals.</p> <p><b>Trial Registration</b></p> <p>This study was nested within the original RapIT randomized controlled trial which was registered on ClinicalTrials.gov (Registration number) NCT01710397 on September 7, 2012 and the South African National Clinical Trials Register DOH-27-0213-4177. The first participant in the RapIT study was enrolled on May 8th, 2013.</p>
Implementing a Comprehensive Prevention of Mother-to-Child Transmission of HIV Program for South African Couples
ClinicalTrials.gov study NCT02085356. IPD Sharing: YES. Countries: 1. Publications: 7.
Antiviral Responses to NNRTI-Based vs. PI-Based ARV Therapy in HIV Infected Infants Who Have or Have Not Received Single Dose NVP for Prevention of Mother-to-Child Transmission of HIV
ClinicalTrials.gov study NCT00307151. IPD Sharing: Not stated. Countries: 7. Publications: 11.
Using Nevirapine to Prevent Mother-to-Child HIV Transmission During Breastfeeding
ClinicalTrials.gov study NCT00074412. IPD Sharing: Not stated. Countries: 4. Publications: 10.
Trizivir Vs. Kaletra and Combivir for the Prevention of Mother-to-Child Transmission of HIV
ClinicalTrials.gov study NCT00270296. IPD Sharing: Not stated. Countries: 1. Publications: 13.
HIV Treatment Reinitiation in Women Who Received Anti-HIV Drugs to Prevent Mother-to-Child Transmission of HIV
ClinicalTrials.gov study NCT00442962. IPD Sharing: Not stated. Countries: 3. Publications: 3.
NNRTI vs PI Regimens for HIV Infected Women After They Have Taken Nevirapine to Prevent Mother-To-Child HIV Transmission
ClinicalTrials.gov study NCT00089505. IPD Sharing: Not stated. Countries: 7. Publications: 14.
Data from: Implementation of Option B and a fixed-dose combination antiretroviral regimen for prevention of mother-to-child transmission of HIV in South Africa: a model of uptake and adherence to care
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Data from: Optimizing prevention of HIV mother to child transmission: duration of antiretroviral therapy and viral suppression at delivery among pregnant Malawian women
Background: Effective antiretroviral therapy during pregnancy minimizes the risk of vertical HIV transmission. Some women present late in their pregnancy for first antenatal visit; whether these women achieve viral suppression by delivery and how suppression varies with time on ART is unclear. Methods: We conducted a prospective cohort study of HIV-infected pregnant women initiating antiretroviral therapy for the first time from June 2015 to November 2016. Multivariable Poisson models with robust variance estimators were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of the association between duration of ART and both viral load (VL) ≥1000 copies/ml and VL ≥40 copies/ml at delivery. Results: Of the 252 women who had viral load testing at delivery, 40 (16%) and 78 (31%) had VL ≥1000 copies/ml and VL ≥40 copies/ml, respectively. The proportion of women with poor adherence to ART was higher among women who were on ART for ≤12 weeks (9/50 = 18.0%) than among those who were on ART for 13-35 weeks (18/194 = 9.3%). Compared to women who were on ART for ≤12 weeks, women who were on ART for 13-20 weeks (RR = 0.52; 95% CI: 0.36-0.74) or 21-35 weeks (RR = 0.26; 95% CI: 0.14-0.48) had a lower risk of VL ≥40 copies/ml at delivery. Similar comparisons for VL ≥1000 copies/ml at delivery showed decrease in risk although not significant for those on ART 13-20 weeks. Conclusion: Longer duration of ART during pregnancy was associated with suppressed viral load at delivery. Early ANC attendance in pregnancy to facilitate prompt ART initiation for HIV-positive women is essential in the effort to eliminate HIV vertical transmission.
Male Involvement in Antenatal Care and the Prevention Programme of Mother-to-child Transmission of HIV in Uganda
ClinicalTrials.gov study NCT01144234. IPD Sharing: Not stated. Countries: 1. Publications: 2.
Improving Uptake of Early Infant Diagnosis of HIV for the Prevention of Mother-to-child Transmission of HIV
ClinicalTrials.gov study NCT01433185. IPD Sharing: Not stated. Countries: 1. Publications: 2.
Comparison of Anti-HIV Drug Combinations to Prevent Mother-to-Child Transmission of HIV
ClinicalTrials.gov study NCT00086359. IPD Sharing: Not stated. Countries: 2. Publications: 5.
Impact of COVID-19 on Provision and Uptake of Prevention of Mother-to-child Transmission of HIV Services in Zimbabwe
ClinicalTrials.gov study NCT04782739. IPD Sharing: Not stated. Countries: 1. Publications: 3.
Nevirapine (NVP) Use to Prevent Mother-to-Child Transmission of HIV
ClinicalTrials.gov study NCT00074399. IPD Sharing: Not stated. Countries: 1. Publications: 1.
Voluntary HIV Counseling, Testing, and Medication for Pregnant Women to Prevent Mother-to-Child HIV Transmission
ClinicalTrials.gov study NCT00084045. IPD Sharing: Not stated. Countries: 1. Publications: 5.
Mobile Phone Technology for Prevention of Mother-to-Child Transmission of HIV: Acceptability, Effectiveness, and Cost
ClinicalTrials.gov study NCT01645865. IPD Sharing: Not stated. Countries: 1. Publications: 1.
Adapting the HITSystem to Support Prevention of Mother-to-child HIV Transmission
ClinicalTrials.gov study NCT02726607. IPD Sharing: NO. Countries: 2. Publications: 2.
Safety Study of a Tenofovir-containing Drug Regimen for the Prevention of Mother-to-child Transmission of HIV and HBV
ClinicalTrials.gov study NCT01125696. IPD Sharing: Not stated. Countries: 1. Publications: 1.
Shortened Zidovudine Regimens to Prevent Mother-to-Child Transmission of HIV Type 1
ClinicalTrials.gov study NCT00386230. IPD Sharing: Not stated. Countries: 1. Publications: 2.
Prevention of Mother-to-child Transmission of HIV-1 Using a Responsive Intervention
ClinicalTrials.gov study NCT03870438. IPD Sharing: UNDECIDED. Countries: 2. Publications: 3.
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