Pregnancy rates and clinical outcomes among women living with HIV enrolled in HPTN 052.
Sahar Z ZangenehEthan A WilsonSurabhi AhluwaliaDeborah J DonnellYing Q ChenBeatriz GrinsztejnMarineide G MeloSheela V GodboleMina C HosseinipourTaha TahaJohnston KumwendaMarybeth McCauleyMyron S CohenKarin Nielsen-SainesPublished in: AIDS care (2022)
HPTN 052 was a multi-country clinical trial of cART for preventing heterosexual HIV-1 transmission. The study allowed participation of pregnant women and provided access to cART and contraceptives. We explored associations between pregnancy and clinical measures of HIV disease stage and progression. Of 869 women followed for 5.70 (SD = 1.62) years, 94.7% were married/cohabitating, 96% initiated cART, and 76.3% had >2 past pregnancies. Of 337 women who experienced pregnancy, 89.3% were from countries with lower contraceptive coverage, 56.1% first started cART with PI-based regimens and 57.6% were 25-34 years old. Mean cART duration and condom use were similar among pregnant and nonpregnant individuals. Adjusting for confounders, viral load suppression (VLS) was not (aHR(CI) = 0.82(0.61, 1.08)) and CD4 was slightly associated with decreased rates of first pregnancy over time (aHR(CI) = 0.9(0.84, 0.95)); baseline VLS was associated with increased (aRR(CI) = 2.48(1.71, 3.59)) and baseline CD4 was slightly associated with decreased number of pregnancies (aRR(CI) = 0.9(0.85,0.96)) over study duration. Partner seroconversion was univariably associated with higher rates of first pregnancy (HR(CI) = 2.02(1.32,3.07)). Despite a background of higher maternal morbidity and mortality rates, our findings suggest that becoming pregnant does not pose a threat to maternal health in women with HIV when there is access to medical care and antiretroviral treatment.
Keyphrases
- pregnancy outcomes
- pregnant women
- hiv positive
- hiv infected
- hiv testing
- antiretroviral therapy
- human immunodeficiency virus
- men who have sex with men
- hiv aids
- preterm birth
- clinical trial
- hepatitis c virus
- healthcare
- public health
- mental health
- randomized controlled trial
- polycystic ovary syndrome
- south africa
- adipose tissue
- skeletal muscle
- metabolic syndrome
- body mass index
- climate change
- insulin resistance