Viral Suppression and HIV Drug Resistance at 6 Months Among Women in Malawi's Option B+ Program: Results From the PURE Malawi Study

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Mina C HosseinipourPURE Malawi consortium

Abstract

In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health and prevent pediatric HIV infection. For optimal outcomes, women need to achieve HIVRNA suppression. We report 6-month HIVRNA suppression and HIV drug resistance in the PURE study. PURE study was a cluster-randomized controlled trial evaluating 3 strategies for promoting uptake and retention; arm 1: Standard of Care, arm 2: Facility Peer Support, and arm 3: Community Peer support. Pregnant and breastfeeding mothers were enrolled and followed according to Malawi ART guidelines. Dried blood spots for HIVRNA testing were collected at 6 months. Samples with ART failure (HIVRNA ≥1000 copies/ml) had resistance testing. We calculated odds ratios for ART failure using generalized estimating equations with a logit link and binomial distribution. We enrolled 1269 women across 21 sites in Southern and Central Malawi. Most enrolled while pregnant (86%) and were WHO stage 1 (95%). At 6 months, 950/1269 (75%) were retained; 833/950 (88%) had HIVRNA testing conducted, and 699/833 (84%) were suppressed. Among those with HIVRNA ≥1000 copies/ml with successful amplification (N = 55, 41% of...Continue Reading

Associated Clinical Trials

Dec 9, 2013·Sam Phiri, PhD, MSc, DCM

References

Nov 17, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Christopher J HoffmannAlison D Grant
May 11, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nellie Wadonda-KabondoDiane E Bennett
May 11, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nellie Wadonda-KabondoChunfu Yang
May 25, 2013·The Journal of Infectious Diseases·Mina C HosseinipourJean B Nachega
May 6, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Carole L WallisUNKNOWN A5230 team
Jun 8, 2014·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Sarah E RutsteinRonald Mataya

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Citations

Dec 30, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Brandon A KnettelMelissa H Watt
Jun 23, 2018·Current HIV/AIDS Reports·Grace John-Stewart
Mar 17, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Landon MyerSteven J Reynolds
Dec 4, 2019·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Thomas StruyfAnnelies Van Rie
Oct 28, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Risa M HoffmanUNKNOWN PROMISE 1077HS Team

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