Trends in post-partum viral load among women living with perinatal HIV infection in the USA: a prospective cohort study

Publication date: Available online 20 December 2019Source: The Lancet HIVAuthor(s): Kunjal Patel, Brad Karalius, Kathleen Powis, Deborah Kacanek, Claire Berman, Anna-Barbara Moscicki, Mary Paul, Katherine Tassiopoulos, George R Seage, HIV/AIDS Cohort Study (PHACS)SummaryBackgroundSmall studies reported poor post-partum outcomes among young women living with perinatal HIV infection who are now ageing into adulthood and becoming pregnant. For targeted clinical intervention, we sought to identify women in this population at risk of poor post-partum virological control.MethodsWe abstracted data on pregnancy history for women living with perinatal HIV infection in the Pediatric HIV/AIDS Cohort Study-AMP Up protocol, a prospective study of young adults living with perinatal HIV from 14 sites in the USA. Linear models with generalised estimating equations described trends in HIV viral load through 1 year post-pregnancy by pregnancy outcome. We used group-based trajectory modelling to identify viral load trajectory groups in the first post-partum year after livebirths. We then compared sociodemographic and clinical factors across identified groups. We defined viraemia as 400 copies per mL or more.FindingsBetween April 15, 2014, and Oct 1, 2017, we enrolled 323 women, of whom 234 had perinatal HIV infection, and reported age at sexual debut and history of heterosexual vaginal intercourse. Of the 172 pregnancies recorded in these women, 147 (85%, 104 livebirths and 43 spontaneous or el...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research