Imperial College London
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ProfessorAlanWinston

Faculty of Medicine, Department of Infectious Disease

Professor of Genito-Urinary Medicine
 
 
 
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Contact

 

+44 (0)20 3312 1603a.winston

 
 
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Location

 

Winston Churchill WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Huntington:2015:10.1097/QAD.0000000000000826,
author = {Huntington, S and Thorne, C and Newell, M-L and Anderson, J and Taylor, GP and Pillay, D and Hill, T and Tookey, PA and Sabin, C},
doi = {10.1097/QAD.0000000000000826},
journal = {AIDS},
pages = {2269--2278},
title = {The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy},
url = {http://dx.doi.org/10.1097/QAD.0000000000000826},
volume = {29},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART).Methods: Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50copies/ml or less at delivery in 2006–2011, who started life-long cART during pregnancy (n=321) or conceived on cART (n=618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200copies/ml) was assessed by Kaplan–Meier analysis; adjusted hazard ratios (aHRs) for the 0–3 and 3–12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models.Results: In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0–7.7] experienced viral rebound by 3 months, and 2.2% (1.4–3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58–4.39)] but not during the 3–12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22–32%) experienced viral rebound by 3 months, and 3.0% (1.6–4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [<3 months: aHR 6.63 (3.58–12.29); 3–12 months: aHR 4.05 (2.03–8.09)].Conclusion: In women on suppressive cART, the risk of viral rebound is increased following delivery, especially in the first 3 months, which may be related to reduced adherence, indicating the need for additional adherence support for postpartum women.
AU  - Huntington,S
AU  - Thorne,C
AU  - Newell,M-L
AU  - Anderson,J
AU  - Taylor,GP
AU  - Pillay,D
AU  - Hill,T
AU  - Tookey,PA
AU  - Sabin,C
DO  - 10.1097/QAD.0000000000000826
EP  - 2278
PY  - 2015///
SN  - 0269-9370
SP  - 2269
TI  - The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy
T2  - AIDS
UR  - http://dx.doi.org/10.1097/QAD.0000000000000826
UR  - http://hdl.handle.net/10044/1/34246
VL  - 29
ER  -
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