Burden, clinical presentation and risk factors of advanced HIV disease in pregnant Mozambican women
Rattachement africain : Mozambique, es. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Background: Information on the frequency and clinical features of advanced HIV disease (AHD) in pregnancy and its effects on maternal and perinatal outcomes is limited. The objective of this study was to describe the prevalence and clinical presentation of AHD in pregnancy, and to assess the impact of AHD in maternal and perinatal outcomes in Mozambican pregnant women.Methods: This is a prospective and retrospective cohort study including HIV-infected pregnant women who attended the antenatal care (ANC) clinic at the Manhiça District Hospital between 2015 and 2020. Women were followed up for 36 months. Levels of CD4+ cell count were determined to assess AHD immune-suppressive changes. Risk factors for AHD were analyzed and the immune-suppressive changes over time and the effect of AHD on pregnancy outcomes were assessed. Results: A total of 2458 HIV-infected pregnant women were enrolled. The prevalence of AHD at first ANC visit was 14.2% (349/2458). Among women with AHD at enrolment, 76.2% (260/341) were on antiretroviral therapy (ART). The proportion of women with AHD increased with age reaching 20.5% in those older than 35 years of age (p<0.001). Tuberculosis was the only opportunistic infection diagnosed in women with AHD [4.9% (17/349)]. There was a trend for increased CD4+ cell count in women with and without AHD during the follow up period; however, in women with AHD the CD4+ cell count remained below 200 cells/mm³ (p<0.001). Forty-two out of 2458 (1.7%) of the women were severely immunosuppressed (CD4+cell count<50 cells/mm3). Maternal mortality was higher in women with AHD [1.1% (4/349)] versus [0.5% (11/2109]. There were no differences between women with and without AHD in the frequency of prematurity, low birth weight and neonatal HIV infection. Conclusions: After more than two decades of roll out of ART in Mozambique, over 14% and nearly 2% of HIV-infected pregnant women present at first ANC clinic visit with AHD and severe immunosuppression, respectively. Prompt HIV diagnosis in women of childbearing age, effective linkage to HIV care and close monitoring after ART initiation may contribute to reduce this burden and improve maternal and child survival.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Burden, clinical presentation and risk factors of advanced HIV disease in pregnant Mozambican women
- Date Crossref
- 07/07/2022
- Éditeur
- Research Square Platform LLC
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Manhiça Health Research Centre Mozambique (code pays fourni par la source)Structure de recherche
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Barcelona Institute for Global Health pays non établi dans la noticeÉtablissement de santé
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Menéndez Pelayo International University pays non établi dans la noticeUniversité ou école supérieure
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Ministry of Health Mozambique (code pays fourni par la source)Organisme public
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Eduardo Mondlane University Mozambique (code pays fourni par la source)Université ou école supérieure
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Centro de Investigação em Saúde de Manhiça (CISM) pays non établi dans la noticeInstitution
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Ministério de Saúde Maputo (MISAU), Mozambique (ville ou établissement reconnu, pays non nommé)Institution
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Universidade Eduardo Mondlane (UEM) pays non établi dans la noticeUniversité ou école supérieure
Manhiça Health Research Centre (Mozambique), Barcelona Institute for Global Health et Menéndez Pelayo International University, avec 5 autres affiliations. Pays d’affiliation : Mozambique.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.