Byrne, L;
Sconza, R;
Foster, C;
Tookey, PA;
Cortina-Borja, M;
Thorne, C;
(2017)
Pregnancy incidence and outcomes in women with perinatal HIV infection.
AIDS
, 31
(12)
pp. 1745-1754.
10.1097/QAD.0000000000001552.
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Abstract
OBJECTIVE(S): To estimate the incidence of first pregnancy in women living with perinatally-acquired HIV (PHIV) in the UK and to compare pregnancy management and outcomes with age-matched women with behaviourally-acquired HIV (BHIV). DESIGN: The National Study of HIV in Pregnancy and Childhood (NSHPC) is a comprehensive, population-based surveillance study that collects demographic and clinical data on all pregnant women living with HIV, their children, and all HIV-infected children in the UK & Ireland. METHODS: The incident rate ratio (IRR) of first pregnancy was calculated for all females of reproductive age who had been reported to the NSHPC as vertically infected children. These women and their pregnancies were compared to age-matched pregnant women with BHIV. RESULTS: Of the 630 females with PHIV reported in the UK as children, 7% (45) went on to have ≥1 pregnancy, with 70 pregnancies reported. The IRR of first pregnancy was 13 per 1000 woman-years. The BHIV comparison group comprised 118 women (184 pregnancies). Women with PHIV were more likely to be on cART at conception and have a lower baseline CD4 count (p < 0.01 for both). In adjusted analysis, PHIV and a low baseline CD4 count were risk factors for detectable viral load near delivery; older age at conception and being on cART at conception reduced this risk. CONCLUSIONS: Women with PHIV in the UK have a low pregnancy incidence, but those who become pregnant are at risk of detectable viral load near delivery, reflecting their often complex clinical history, adherence and drug resistance issues.
| Type: | Article |
|---|---|
| Title: | Pregnancy incidence and outcomes in women with perinatal HIV infection |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000001552 |
| Publisher version: | http://dx.doi.org/10.1097/QAD.0000000000001552 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | HIV; paediatrics; pregnant women; antiretroviral agents; pregnancy outcome; incidence; viral load; perinatal |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1560518 |
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