부산대학교 도서관

Introduction: Published data on viral suppression among pregnant and breastfeeding women in routine care settings are scarce. Here, we report provincial estimates of undetectable and suppressed viral load among pregnant or breastfeeding women in HIV care in Kinshasa, Democratic Republic of Congo (DRC) and associated risk factors. Methods: This cross-sectional study was conducted as part of a baseline assessment for the CQI-PMTCT study: an ongoing cluster randomized trial to evaluate the effect of continuous quality interventions (CQI) on long-term ART outcomes among pregnant and breastfeeding women (NCT03048669). From November 2016 to June 2018, in each of the 35 Kinshasa provincial health zones (HZ), study teams visited the three busiest maternal and child health clinics, enrolled all HIV-positive pregnant or breastfeeding women ( Results: Of the 1752 eligible women, 1623 had viral load results available, including 38% who had been on ART for 12 months, only 60% and 67% respectively had undetectable or suppressed vira load. Viral load was undetectable in 53%, 48% and 58% of women testing during pregnancy at delivery and in postpartum respectively. In multivariable log binomial models, duration of ART >12 months, older age, being married, disclosure of HIV status, receiving care in an urban health zone or one supported by PEPFAR were all positively associated with viral suppression. Conclusions: The observed high level of detectable viral load suggests that high ART coverage alone without substantia efforts to improve the quality of care for pregnant and breastfeeding women, will not be enough to achieve the goal of virtua elimination of vertical HIV transmission in high-burden and limited resources settings like DRC. Keywords: pregnant women) option B+) treat all) universal coverage) viral suppression) vertical transmission) viral load monitoring) quality of care) HIV
1 | INTRODUCTION Spurred by the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive, new paediatric HIV infections were reduced [...]