Evidence map›Paper›PMID 37303945›Full record

ArticleThe Lancet regional health. Europe2023

Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study.

Paolo Paioni, Karoline Aebi-Popp, Begoña Martinez de Tejada, Christoph Rudin, Enos Bernasconi, Dominique L Braun, Roger Kouyos, Noémie Wagner, Pierre Alex Crisinel, Sabine Güsewell and 7 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Europe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 1 country.

Paolo PaioniDivision of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland.
Karoline Aebi-PoppDepartment of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland.
Begoña Martinez de TejadaDepartment of Obstetrics and Gynecology, University Hospital Geneva, University of Geneva, Switzerland.
Christoph RudinUniversity Children's Hospital Basel, Switzerland.
Enos BernasconiDivision of Infectious Diseases, Ente Ospedaliero Cantonale, University of Geneva and University of Southern Switzerland, Lugano, Switzerland.
Dominique L BraunDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
Roger KouyosDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
Noémie WagnerPediatric Infectious Diseases Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals Geneva, Switzerland.
Pierre Alex CrisinelUnit of Pediatric Infectious Diseases and Vaccinology, Department Women-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Sabine GüsewellCantonal Hospital St. Gallen, Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland.
Katharine E A DarlingInfectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Andrea DuppenthalerDepartment of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Marc BaumannDepartment of Obstetrics and Gynecology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Christian PolliDepartment of Obstetrics and Gynecology, Regional Hospital, Lugano, Switzerland.
Tina FischerDepartment of Obstetrics, Community Hospital St. Gallen, St. Gallen, Switzerland.
Christian R KahlertCantonal Hospital St. Gallen, Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland.
Swiss HIV Cohort Study (SHCS) and the Swiss Mother and Child HIV Cohort Study (MoCHiV)
University of St.Gallen · CHUniversity of Bern · CHUniversity of Geneva · CHUniversity of Lausanne · CHOspedale regionale di Lugano · CHUniversity Hospital of Zurich · CHUniversity Children's Hospital Zurich · CHUniversity Hospital of Geneva · CHUniversity Children’s Hospital Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Low rates of postnatal retention in HIV care and viral suppression have been reported in women living with HIV (WLWH) despite viral suppression at delivery. At the same time, postpartum follow-up is of crucial importance in light of the increasing support offered in many resource-rich countries including Switzerland to WLWH choosing to breastfeed their infant, if optimal scenario criteria are met. Methods: We longitudinally investigated retention in HIV care, viral suppression, and infant follow-up in a prospective multicentre HIV cohort study of WLWH in the optimal scenario who had a live birth between January 2000 and December 2018. Risk factors for adverse outcomes in the first year postpartum were assessed using logistic and proportional hazard models. Findings: Overall, WLWH were retained in HIV care for at least six months after 94.2% of the deliveries (694/737). Late start of combination antiretroviral therapy (cART) during the third trimester was found to be the main risk factor for failure of retention in HIV care (crude odds ratio [OR] 3.91; 95% confidence interval [CI], 1.50-10.22; p = 0.005). Among mothers on cART until at least one year after delivery, 4.4% (26/591) experienced viral failure, with illicit drugs use being the most important risk factor (hazard ratio [HR], 13.2; 95% CI, 2.35-73.6; p = 0.003). The main risk factors for not following the recommendations regarding infant follow-up was maternal depression (OR, 3.52; 95% CI, 1.18-10.52; p = 0.024). Interpretation: Although the results are reassuring, several modifiable risk factors for adverse postpartum outcome, such as late treatment initiation and depression, were identified. These factors should be addressed in HIV care of all WLWH, especially those opting to breastfeed in resource-rich countries. Funding: This study has been financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #201369), by SHCS project 850 and by the SHCS research foundation.

Indexed as

BreastfeedingInfant follow-upPostpartum HIV care engagementPostpartum periodRetention in HIV careViral suppression

Identifiers

PMID37303945
PMCPMC10250913
OpenAlexW4378975025

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.