Prevalence of undetectable and suppressed viral load in HIV‑infected pregnant women initiating Option B+ in Uganda: an observational study nested within a randomized controlled trial

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dc.contributor.authorGabagaya, Grace
dc.contributor.authorRukundo, Gordon
dc.contributor.authorAmone, Alexander
dc.contributor.authorWavamunno, Priscilla
dc.contributor.authorNamale‑Matovu, Joyce
dc.contributor.authorLubega, Irene
dc.contributor.authorNakabiito, Clemensia
dc.contributor.authorNamukwaya, Zikulah
dc.contributor.authorNolan, Monica
dc.contributor.authorMalamba, Samuel S.
dc.contributor.authorKing, Rachel
dc.contributor.authorHomsy, Jaco ,
dc.contributor.authorGlenn Fowler, Mary
dc.contributor.authorMusoke, Philippa
dc.date.accessioned2021-12-10T12:55:42Z
dc.date.available2021-12-10T12:55:42Z
dc.date.issued2021
dc.description.abstractViral load (VL) testing is key in monitoring adherence to antiretroviral therapy (ART) and documenting HIV treatment response. As per HIV treatment guidelines in Uganda, the first VL test is recommended 6 months after initiation of ART. Undetectable VL (uVL) at ART initiation may be helpful in detecting elite controllers in the absence of previous ART use. We investigated viral suppression at ART initiation among a cohort of HIV-positive pregnant women enrolled in the Friends for Life Circles (FLC) for Option B+ randomized controlled trial (RCT). Methods: Pregnant women ≥ 18 years of age testing positive for HIV at their first antenatal care visit and starting on ART Option B+ as per the National PMTCT Program guidelines were enrolled into the FLC for Option B+ RCT in urban Kampala and rural Mityana districts of Uganda. Each participant had whole blood samples collected at enrolment to assess baseline VL. Plasma HIV-1 RNA was quantified using COBAS Ampliprep /COBAS Taqman. Baseline VL below 400 RNA copies/ml was considered as viral suppression while baseline VL below 20 RNA copies/ml was considered uVL. Results: The mean duration from the date of ART initiation to time of sample collection for baseline VL assessment was 4.4 days (SD 3.6). Of the 532 HIV-positive pregnant women enrolled in the FLC for Option B+ study and newly starting Option B+ without a self-reported history of prior ART use, 29 (5.5%) had uVL and 113 (21.4%) had suppressed VL at baseline. There was no association between participants’ age, gravidity, marital status, mean monthly income, educational level, disclosure of HIV status to partner, and uVL or viral suppression at baseline. However, nondisclosure of HIV status to any other person was associated with decreased odds of viral suppression at baseline (OR 0.640; 0.416–0.982). Conclusion: Twenty-one percent of HIV-positive Ugandan pregnant women initiating ART (Option B+) showed virological suppression at baseline and were presumed to be “elite controllers” or to have misreported being ART-naive.en_US
dc.identifier.citationGabagaya, G., Rukundo, G., Amone, A., Wavamunno, P., Namale-Matovu, J., Lubega, I., ... & Musoke, P. (2021). Prevalence of undetectable and suppressed viral load in HIV-infected pregnant women initiating Option B+ in Uganda: an observational study nested within a randomized controlled trial. BMC infectious diseases, 21(1), 1-7.doi:10.1186/s12879-021-06608-4en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-021-06608-4
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/256
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.subjectHIVen_US
dc.subjectPregnancyen_US
dc.subjectViral loaden_US
dc.subjectViral or virological suppressionen_US
dc.subjectUgandaen_US
dc.subjectHIV transmissionen_US
dc.subjectOption B+en_US
dc.subject, Antiretroviral therapyen_US
dc.titlePrevalence of undetectable and suppressed viral load in HIV‑infected pregnant women initiating Option B+ in Uganda: an observational study nested within a randomized controlled trialen_US
dc.typeArticleen_US
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