dc.contributor.author | Matthews, Lynn T. | |
dc.contributor.author | Kaida, Angela | |
dc.contributor.author | Kanters, Steven | |
dc.contributor.author | Byakwaga, Helen | |
dc.contributor.author | Mocello, A. Rain | |
dc.contributor.author | Muzoora, Conrad | |
dc.contributor.author | Kembabazi, Annet | |
dc.contributor.author | Haberer, Jessica E | |
dc.contributor.author | Martin, Jeffrey N | |
dc.contributor.author | Bangsberg, David R | |
dc.contributor.author | Hunt, Peter W | |
dc.date.accessioned | 2022-06-14T09:19:00Z | |
dc.date.available | 2022-06-14T09:19:00Z | |
dc.date.issued | 2013 | |
dc.identifier.citation | Matthews, L. T., Kaida, A., Kanters, S., Byakwaga, H., Mocello, A. R., Muzoora, C., ... & Hunt, P. W. (2013). HIV-infected women on antiretroviral treatment in Uganda have increased mortality during pregnant and postpartum periods. AIDS (London, England), 27(0 1), S105. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/2120 | |
dc.description.abstract | Objective: To assess the impact of pregnancy on mortality among HIV-infected Ugandan women initiating antiretroviral therapy (ART).
Design: Prospective cohort study.
Methods: HIV-infected women initiating ART in the Uganda AIDS Rural Treatment Outcomes
study was assessed quarterly for self-reported pregnancy. The association between pregnant/ postpartum (“pregnancy-related”) follow-up periods and mortality was assessed with Cox proportional hazards models adjusted for age, CD4 cell count, plasma HIV-1 RNA levels, and ART duration.
Results: 354 women with median age 33 years (IQR: 27-37) and CD4 142 cells/mm3 (IQR: 82-213) were followed for a median of 4.0 years (IQR: 2.5-4.8) after ART initiation, with 3% and 6% loss-to-follow-up at years 1 and 3. 109 women experienced pregnancy. Five deaths occurred during pregnancy-related follow-up and 16 during non-pregnancy-related follow-up, for crude mortality rates during the first year after ART initiation of 12.57/100 PYs and 3.53/100 PYs (Rate
Ratio 3.56, 95% CI: 0.97-11.07). In adjusted models, the impact of pregnancy-related follow-up on mortality was highest at ART initiation (aHR: 21.48, 95% CI: 3.73 - 123.51), decreasing to 13.44 (95% CI 3.28 – 55.11) after 4 months, 8.28 (95% CI 2.38 – 28.88) after 8 months, 5.18 (95% CI: 1.36 - 19.71) after one year, and 1.25 (95% CI: 0.10 - 15.58) after two years on ART. Four of five maternal deaths occurred postpartum.
Conclusions: Pregnancy and the postpartum period were associated with increased mortality in HIV-infected women initiating ART, particularly during early ART. Contraception proximate to ART initiation, earlier ART initiation, and careful monitoring during the postpartum period may reduce maternal mortality in this setting. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | AIDS | en_US |
dc.subject | HIV | en_US |
dc.subject | Maternal health | en_US |
dc.subject | Maternal mortality | en_US |
dc.subject | Immune reconstitution | en_US |
dc.subject | Pregnancy | en_US |
dc.subject | Postpartum | en_US |
dc.subject | Antiretroviral therapy | en_US |
dc.subject | Mortality | en_US |
dc.subject | Africa | en_US |
dc.subject | Women | en_US |
dc.title | HIV-infected women on antiretroviral treatment in Uganda have increased mortality during pregnant and postpartum periods | en_US |
dc.type | Article | en_US |