ArticlePloS one2018
Optimizing prevention of HIV mother to child transmission: Duration of antiretroviral therapy and viral suppression at delivery among pregnant Malawian women.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Pooled it
- Pooled it
- Evidence of sociodemographic heterogeneity across the HIV treatment cascade and progress towards 90-90-90 in sub-Saharan Africa - a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Effect of Enhanced Adherence Package on Early ART Uptake Among HIV-Positive Pregnant Women in Zambia: An Individual Randomized Controlled Trial.AIDS and behavior · 2021Trial
- Trial
- HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI-PMTCT study.Journal of the International AIDS Society · 2019Trial
- Low adherence to Option B+ antiretroviral therapy among pregnant women and lactating mothers in eastern Tanzania.PloS one · 2019Trial
- HIV vertical transmission linked to virological failure in pregnant women on ART.AIDS research and therapy · 2025Article
- Effect of in utero and lactational exposure to antiretroviral therapy on the gut microbial composition and metabolic function in aged rat offspring.Experimental biology and medicine (Maywood, N.J.) · 2025Article
- Article
- Association of comprehensiveness of antiretroviral care and detectable HIV viral load suppression among pregnant and postpartum women in the Democratic Republic of the Congo: a cross-sectional study.Frontiers in global women's health · 2024Article
- Article
- Three-year outcomes for women newly initiated on lifelong antiretroviral therapy during pregnancy - Malawi option B.AIDS research and therapy · 2023Article
- Voluntary Pregnancy Screening at Syringe Exchanges: A Feasibility Study.Journal of prevention and health promotion · 2021Article
- Timing of HIV testing among pregnant and breastfeeding women and risk of mother-to-child HIV transmission in Malawi: a sampling-based cohort study.Journal of the International AIDS Society · 2021Article
- Effectiveness of Maternal Transmission Risk Stratification in Identification of Infants for HIV Birth Testing: Lessons From Zimbabwe.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Viral suppression and factors associated with failure to achieve viral suppression among pregnant women in South Africa.AIDS (London, England) · 2020Article
- Detectable HIV-RNA Viral Load Among HIV-Infected Pregnant Women on Treatment in Northern Uganda.International journal of MCH and AIDS · 2020Article
- Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs.Journal of virus eradication · 2018Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundEffective antiretroviral therapy during pregnancy minimizes the risk of vertical HIV transmission. Some women present late in their pregnancy for first antenatal visit; whether these women achieve viral suppression by delivery and how suppression varies with time on ART is unclear.
methodsWe conducted a prospective cohort study of HIV-infected pregnant women initiating antiretroviral therapy for the first time at Bwaila Hospital in Lilongwe, Malawi from June 2015 to November 2016. Multivariable Poisson models with robust variance estimators were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of the association between duration of ART and both viral load (VL) ≥1000 copies/ml and VL ≥40 copies/ml at delivery.
resultsOf the 252 women who had viral load testing at delivery, 40 (16%) and 78 (31%) had VL ≥1000 copies/ml and VL ≥40 copies/ml, respectively. The proportion of women with poor adherence to ART was higher among women who were on ART for ≤12 weeks (9/50 = 18.0%) than among those who were on ART for 13-35 weeks (18/194 = 9.3%). Compared to women who were on ART for ≤12 weeks, women who were on ART for 13-20 weeks (RR = 0.52; 95% CI: 0.36-0.74) or 21-35 weeks (RR = 0.26; 95% CI: 0.14-0.48) had a lower risk of VL ≥40 copies/ml at delivery. Similar comparisons for VL ≥1000 copies/ml at delivery showed decrease in risk although not significant for those on ART 13-20 weeks.
conclusionLonger duration of ART during pregnancy was associated with suppressed viral load at delivery. Early ANC attendance in pregnancy to facilitate prompt ART initiation for HIV-positive women is essential in the effort to eliminate HIV vertical transmission.
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