The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy
The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART). Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with...
Gespeichert in:
Veröffentlicht in: | AIDS (London) 2015-11, Vol.29 (17), p.2269-2278 |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 2278 |
---|---|
container_issue | 17 |
container_start_page | 2269 |
container_title | AIDS (London) |
container_volume | 29 |
creator | Huntington, Susie Thorne, Claire Newell, Marie-Louise Anderson, Jane Taylor, Graham P Pillay, Deenan Hill, Teresa Tookey, Pat A Sabin, Caroline |
description | The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART).
Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50 copies/ml or less at delivery in 2006-2011, who started life-long cART during pregnancy (n = 321) or conceived on cART (n = 618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200 copies/ml) was assessed by Kaplan-Meier analysis; adjusted hazard ratios (aHRs) for the 0-3 and 3-12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models.
In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0-7.7] experienced viral rebound by 3 months, and 2.2% (1.4-3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58-4.39)] but not during the 3-12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22-32%) experienced viral rebound by 3 months, and 3.0% (1.6-4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [ |
doi_str_mv | 10.1097/QAD.0000000000000826 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4631122</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1808696424</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-23e2b5f9b66c58bece0e528884e17e7b55debc1ad5cd2562d45541719e67a0573</originalsourceid><addsrcrecordid>eNqFkUtLxDAUhYMoOj7-gUiWbqpJmlc3gvgGQQRdh7S91WibjElnZP69GUZF3Xg3d3HO-bjJQWifkiNKKnV8f3p-RH6OZnINTShXZSGEoutoQpisiqpUZAttp_SSPYJovYm2mBScK0ImyD48A44uveLQ4bmLtscR6jDzLXYej1lcgI3YdiNE3ELv5hAXS-k9DOCzd7DOO_-Eg8fWjy7CGMOKk8PRThe7aKOzfYK9z72DHi8vHs6ui9u7q5uz09ui4ZyOBSuB1aKraikboWtogIBgWmsOVIGqhWihbqhtRdMyIVnLheBU0QqkskSocgedrLjTWT1A24Af8xVmGt1g48IE68xvxbtn8xTmhsuSUsYy4PATEMPbDNJoBpca6HvrIcySoZpoWUnO-P9WVVKl8xcvqXxlbWJIKUL3fRElZlmkyUWav0Xm2MHP13yHvporPwBwkZpo</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1731784472</pqid></control><display><type>article</type><title>The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Journals@Ovid Complete</source><creator>Huntington, Susie ; Thorne, Claire ; Newell, Marie-Louise ; Anderson, Jane ; Taylor, Graham P ; Pillay, Deenan ; Hill, Teresa ; Tookey, Pat A ; Sabin, Caroline</creator><creatorcontrib>Huntington, Susie ; Thorne, Claire ; Newell, Marie-Louise ; Anderson, Jane ; Taylor, Graham P ; Pillay, Deenan ; Hill, Teresa ; Tookey, Pat A ; Sabin, Caroline ; UK Collaborative HIV Cohort (UK CHIC) Study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC)</creatorcontrib><description>The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART).
Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50 copies/ml or less at delivery in 2006-2011, who started life-long cART during pregnancy (n = 321) or conceived on cART (n = 618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200 copies/ml) was assessed by Kaplan-Meier analysis; adjusted hazard ratios (aHRs) for the 0-3 and 3-12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models.
In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0-7.7] experienced viral rebound by 3 months, and 2.2% (1.4-3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58-4.39)] but not during the 3-12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22-32%) experienced viral rebound by 3 months, and 3.0% (1.6-4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [<3 months: aHR 6.63 (3.58-12.29); 3-12 months: aHR 4.05 (2.03-8.09)].
In women on suppressive cART, the risk of viral rebound is increased following delivery, especially in the first 3 months, which may be related to reduced adherence, indicating the need for additional adherence support for postpartum women.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0000000000000826</identifier><identifier>PMID: 26544700</identifier><language>eng</language><publisher>England: Lippincott Williams & Wilkins</publisher><subject>Adult ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral Therapy, Highly Active ; Clinical Science ; Female ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - virology ; Humans ; Ireland ; Kaplan-Meier Estimate ; Lentivirus ; Middle Aged ; Parturition ; Postpartum Period ; Pregnancy ; Recurrence ; Retroviridae ; Risk Assessment ; United Kingdom ; Viral Load</subject><ispartof>AIDS (London), 2015-11, Vol.29 (17), p.2269-2278</ispartof><rights>Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-23e2b5f9b66c58bece0e528884e17e7b55debc1ad5cd2562d45541719e67a0573</citedby><cites>FETCH-LOGICAL-c441t-23e2b5f9b66c58bece0e528884e17e7b55debc1ad5cd2562d45541719e67a0573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26544700$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huntington, Susie</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><creatorcontrib>Newell, Marie-Louise</creatorcontrib><creatorcontrib>Anderson, Jane</creatorcontrib><creatorcontrib>Taylor, Graham P</creatorcontrib><creatorcontrib>Pillay, Deenan</creatorcontrib><creatorcontrib>Hill, Teresa</creatorcontrib><creatorcontrib>Tookey, Pat A</creatorcontrib><creatorcontrib>Sabin, Caroline</creatorcontrib><creatorcontrib>UK Collaborative HIV Cohort (UK CHIC) Study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC)</creatorcontrib><title>The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART).
Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50 copies/ml or less at delivery in 2006-2011, who started life-long cART during pregnancy (n = 321) or conceived on cART (n = 618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200 copies/ml) was assessed by Kaplan-Meier analysis; adjusted hazard ratios (aHRs) for the 0-3 and 3-12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models.
In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0-7.7] experienced viral rebound by 3 months, and 2.2% (1.4-3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58-4.39)] but not during the 3-12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22-32%) experienced viral rebound by 3 months, and 3.0% (1.6-4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [<3 months: aHR 6.63 (3.58-12.29); 3-12 months: aHR 4.05 (2.03-8.09)].
In women on suppressive cART, the risk of viral rebound is increased following delivery, especially in the first 3 months, which may be related to reduced adherence, indicating the need for additional adherence support for postpartum women.</description><subject>Adult</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Clinical Science</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - virology</subject><subject>Humans</subject><subject>Ireland</subject><subject>Kaplan-Meier Estimate</subject><subject>Lentivirus</subject><subject>Middle Aged</subject><subject>Parturition</subject><subject>Postpartum Period</subject><subject>Pregnancy</subject><subject>Recurrence</subject><subject>Retroviridae</subject><subject>Risk Assessment</subject><subject>United Kingdom</subject><subject>Viral Load</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtLxDAUhYMoOj7-gUiWbqpJmlc3gvgGQQRdh7S91WibjElnZP69GUZF3Xg3d3HO-bjJQWifkiNKKnV8f3p-RH6OZnINTShXZSGEoutoQpisiqpUZAttp_SSPYJovYm2mBScK0ImyD48A44uveLQ4bmLtscR6jDzLXYej1lcgI3YdiNE3ELv5hAXS-k9DOCzd7DOO_-Eg8fWjy7CGMOKk8PRThe7aKOzfYK9z72DHi8vHs6ui9u7q5uz09ui4ZyOBSuB1aKraikboWtogIBgWmsOVIGqhWihbqhtRdMyIVnLheBU0QqkskSocgedrLjTWT1A24Af8xVmGt1g48IE68xvxbtn8xTmhsuSUsYy4PATEMPbDNJoBpca6HvrIcySoZpoWUnO-P9WVVKl8xcvqXxlbWJIKUL3fRElZlmkyUWav0Xm2MHP13yHvporPwBwkZpo</recordid><startdate>201511</startdate><enddate>201511</enddate><creator>Huntington, Susie</creator><creator>Thorne, Claire</creator><creator>Newell, Marie-Louise</creator><creator>Anderson, Jane</creator><creator>Taylor, Graham P</creator><creator>Pillay, Deenan</creator><creator>Hill, Teresa</creator><creator>Tookey, Pat A</creator><creator>Sabin, Caroline</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T2</scope><scope>7T5</scope><scope>7U2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>201511</creationdate><title>The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy</title><author>Huntington, Susie ; Thorne, Claire ; Newell, Marie-Louise ; Anderson, Jane ; Taylor, Graham P ; Pillay, Deenan ; Hill, Teresa ; Tookey, Pat A ; Sabin, Caroline</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-23e2b5f9b66c58bece0e528884e17e7b55debc1ad5cd2562d45541719e67a0573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Clinical Science</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - virology</topic><topic>Humans</topic><topic>Ireland</topic><topic>Kaplan-Meier Estimate</topic><topic>Lentivirus</topic><topic>Middle Aged</topic><topic>Parturition</topic><topic>Postpartum Period</topic><topic>Pregnancy</topic><topic>Recurrence</topic><topic>Retroviridae</topic><topic>Risk Assessment</topic><topic>United Kingdom</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huntington, Susie</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><creatorcontrib>Newell, Marie-Louise</creatorcontrib><creatorcontrib>Anderson, Jane</creatorcontrib><creatorcontrib>Taylor, Graham P</creatorcontrib><creatorcontrib>Pillay, Deenan</creatorcontrib><creatorcontrib>Hill, Teresa</creatorcontrib><creatorcontrib>Tookey, Pat A</creatorcontrib><creatorcontrib>Sabin, Caroline</creatorcontrib><creatorcontrib>UK Collaborative HIV Cohort (UK CHIC) Study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Safety Science and Risk</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huntington, Susie</au><au>Thorne, Claire</au><au>Newell, Marie-Louise</au><au>Anderson, Jane</au><au>Taylor, Graham P</au><au>Pillay, Deenan</au><au>Hill, Teresa</au><au>Tookey, Pat A</au><au>Sabin, Caroline</au><aucorp>UK Collaborative HIV Cohort (UK CHIC) Study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2015-11</date><risdate>2015</risdate><volume>29</volume><issue>17</issue><spage>2269</spage><epage>2278</epage><pages>2269-2278</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART).
Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50 copies/ml or less at delivery in 2006-2011, who started life-long cART during pregnancy (n = 321) or conceived on cART (n = 618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200 copies/ml) was assessed by Kaplan-Meier analysis; adjusted hazard ratios (aHRs) for the 0-3 and 3-12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models.
In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0-7.7] experienced viral rebound by 3 months, and 2.2% (1.4-3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58-4.39)] but not during the 3-12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22-32%) experienced viral rebound by 3 months, and 3.0% (1.6-4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [<3 months: aHR 6.63 (3.58-12.29); 3-12 months: aHR 4.05 (2.03-8.09)].
In women on suppressive cART, the risk of viral rebound is increased following delivery, especially in the first 3 months, which may be related to reduced adherence, indicating the need for additional adherence support for postpartum women.</abstract><cop>England</cop><pub>Lippincott Williams & Wilkins</pub><pmid>26544700</pmid><doi>10.1097/QAD.0000000000000826</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0269-9370 |
ispartof | AIDS (London), 2015-11, Vol.29 (17), p.2269-2278 |
issn | 0269-9370 1473-5571 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4631122 |
source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
subjects | Adult Anti-Retroviral Agents - therapeutic use Antiretroviral Therapy, Highly Active Clinical Science Female HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - virology Humans Ireland Kaplan-Meier Estimate Lentivirus Middle Aged Parturition Postpartum Period Pregnancy Recurrence Retroviridae Risk Assessment United Kingdom Viral Load |
title | The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T15%3A22%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20risk%20of%20viral%20rebound%20in%20the%20year%20after%20delivery%20in%20women%20remaining%20on%20antiretroviral%20therapy&rft.jtitle=AIDS%20(London)&rft.au=Huntington,%20Susie&rft.aucorp=UK%20Collaborative%20HIV%20Cohort%20(UK%20CHIC)%20Study%20and%20the%20UK%20and%20Ireland%20National%20Study%20of%20HIV%20in%20Pregnancy%20and%20Childhood%20(NSHPC)&rft.date=2015-11&rft.volume=29&rft.issue=17&rft.spage=2269&rft.epage=2278&rft.pages=2269-2278&rft.issn=0269-9370&rft.eissn=1473-5571&rft_id=info:doi/10.1097/QAD.0000000000000826&rft_dat=%3Cproquest_pubme%3E1808696424%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1731784472&rft_id=info:pmid/26544700&rfr_iscdi=true |