ArticleJournal of acquired immune deficiency syndromes (1999)2012
Consideration of postpartum management in HIV-positive Haitian women: an analysis of CD4 decline, mortality, and follow-up after delivery.
Article in Journal of acquired immune deficiency syndromes (1999), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Pooled it
- Maternal health outcomes among HIV-infected breastfeeding women with high CD4 counts: results of a treatment strategy trial.HIV clinical trials · 2018Trial
- HIV disease progression in the first year after delivery among African women followed in the HPTN 046 clinical trial.Journal of acquired immune deficiency syndromes (1999) · 2013Trial
- Treating loss-to-follow-up as a missing data problem: a case study using a longitudinal cohort of HIV-infected patients in Haiti.BMC public health · 2018Article
- Prevalence of depressive symptoms in pregnant and postnatal HIV-positive women in Ukraine: a cross-sectional survey.Reproductive health · 2016Observational
- Maternal Highly Active Antiretroviral Therapy and Child HIV-Free Survival in Malawi, 2004-2009.Maternal and child health journal · 2016Article
- Retention in Care among HIV-Infected Pregnant Women in Haiti with PMTCT Option B.AIDS research and treatment · 2016Article
- Immunologic status and virologic outcomes in repeat pregnancies to HIV-positive women not on antiretroviral therapy at conception: a case for lifelong antiretroviral therapy?AIDS (London, England) · 2014Article
- Reproductive and maternal healthcare needs of HIV infected women.Current HIV/AIDS reports · 2013Review
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundA previous study at the GHESKIO HIV clinic confirmed that highly active antiretroviral therapy (HAART) prophylaxis reduced mother-to-child transmission (MTCT) and infant mortality in Haiti. This analysis looks at maternal outcomes in this cohort after delivery.
methodsRecords of 508 HIV-positive Haitian women who delivered between 1999 and 2005 were analyzed. We examined mortality, loss to follow-up, time to death or HAART initiation, and time of decline of CD4 count to 350 cells/μL.
resultsOne hundred seventy women reached a CD4 ≤200 or developed clinical AIDS and were started on long-term HAART. The median CD4 count at HAART initiation was 178 (interquartile range, 106-227). CD4 decline was stratified by CD4 at delivery to project the mean months to a CD4 of 350. With an initial CD4 of 350-499 cells/μL, it was 19 months (95% confidence interval: 14 to 28) while with a CD4 >500 cells/μL, it was 71 months (95% confidence interval: 59 to 88). At study close, 257 women remained in follow-up, with loss to follow-up 3 times less in those on HAART (3.2/100 person-years) than those not on HAART (9.8/100 person-years).
conclusionsThe threshold for starting treatment was often missed in HIV-infected women after delivery. Success of follow-up of women after delivery was favorably influenced by being on HAART. Women with high (>500) initial CD4 counts had a protracted time (5-7 years) before they reach a threshold CD4 count, in contrast to those with CD4 <500 cells/μL. Strategies for postpartum treatment of women should be informed by the speed with which they are likely to progress.
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