Viral Suppression and Resistance in a Cohort of Perinatally-HIV Infected (PHIV+) Pregnant Women

Maria Letícia Cruz, Edwiges Santos, Maria De Lourdes Benamor Teixeira, Monica Poletti, Carolina Sousa, Maria Isabel Gouvea, Karin Nielsen-Saines and Esaú João
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Maria Letícia Cruz: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
Edwiges Santos: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
Maria De Lourdes Benamor Teixeira: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
Monica Poletti: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
Carolina Sousa: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
Maria Isabel Gouvea: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
Karin Nielsen-Saines: School of Medicine, David Geffen University of California, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
Esaú João: Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil

IJERPH, 2016, vol. 13, issue 6, 1-6

Abstract: Our objective was to describe viral suppression and antiretroviral (ARV) resistance mutations in an ongoing cohort of perinatally-infected HIV+ (PHIV+) pregnant women. Descriptive analysis was performed using SPSS 18.0. From 2011 to 2014, we followed 22 PHIV+ pregnant women. Median age at prenatal entry was 19 years (Interquartile range (IQR) 17.6–21.0); 86% had an AIDS diagnosis; 81% had disclosed their HIV status to partner 11. The median age at HIV diagnosis was 8.3 y (IQR 4.0–13.6), the median age at sexual debut was 16 years (IQR 14–18). At the time of prenatal care initiation, four (18%) were on their first antiretroviral treatment (ART), eight (36%) in their second regimen and nine (41%) in their third regimen or beyond, and one had no data. Seventeen of 22 (77%) had HIV-viral load (VL) > 50 copies/mL at prenatal care entry, 16 had a genotyping exam performed. Seventeen of 22 PHIV+ had VL results near delivery: 7/17 (41%) had VL < 50 copies/mL. Among those who had genotyping at prenatal entry, 11/16 (69%) had mutations associated with ARV resistance. The most frequent major mutations were K103N, M184V, T215, M41L, D67N at reverse transcriptase gene and M46, I54V and V82A at protease gene. No vertical transmissions occurred. Management of pregnancy among PHIV+ is challenging. Individualized ART are needed to achieve viral suppression in a highly ART-exposed subpopulation.

Keywords: HIV infection; pregnant women; vertical infection transmission; drug resistance; mutation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:13:y:2016:i:6:p:568-:d:71593

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