One-year outcomes of women started on antiretroviral therapy during pregnancy before and after the implementation of Option B+ in Malawi: A retrospective chart review

World Journal of AIDS
Alfred A KamuyangoRisa M Hoffman

Abstract

To compare one-year outcomes of women started on antiretroviral therapy (ART) during pregnancy in the pre-Option B+ era to those in the Option B+ era. A retrospective chart review was performed at three sites in Malawi. Women were included in the 'pre-Option B+' cohort if they started ART during pregnancy for a CD4 count < 350 cells/mm(3) or WHO 3/4 condition and in the 'Option B+' cohort if they started ART during pregnancy regardless of CD4 count or clinical stage. One-year outcomes were compared using Fisher's exact and ANOVA F-tests. A higher proportion of women in the pre-Option B+ cohort started ART at WHO stage 3/4 (11.9% versus 1.1%, P < 0.001), switched ART regimens (5.9% versus 0%, P = 0.002), or died in the first year after starting treatment (3.9% versus .5%, P = 0.05). While more women in the Option B+ cohort had poor adherence or defaulted, these differences were not significant. At our study sites, the transition to Option B+ has been associated with ART initiation in women with less advanced HIV infection, improved medication tolerability, and lower mortality. Further research is needed to better understand outcomes of Option B+.

Citations

May 21, 2016·Tropical Medicine & International Health : TM & IH·Wingston F Ng'ambiSam Phiri
Jan 1, 2015·Journal of the International AIDS Society·Manjulaa NarasimhanMarlène Bras
Dec 30, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Brandon A KnettelMelissa H Watt
Jan 9, 2019·Archives of public health = Archives belges de santé publique·Brian MuyundaCharles Michelo
Feb 20, 2021·Southern African Journal of HIV Medicine·Mildred Lusaka, Talitha Crowley
Jan 1, 2019·Journal of Loss & Trauma·Godfrey A KisigoMelissa H Watt

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