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Characterizing viral load burden among HIV-infected women around the time of delivery: Findings from four tertiary obstetric units in Gauteng, South Africa

Journal of Acquired Immune Deficiency Syndromes Mar 08, 2020

Moyo F, Haeri Mazanderani A, Murray T, et al. - Given the requirement of sustained viral load suppression during pregnancy and breastfeeding among women living with HIV (WLHIV) for elimination of mother-to-child transmission of HIV, researchers here examined maternal VL burden around the time of delivery at 4 tertiary obstetric units (TOUs) in Gauteng Province. In South Africa, antenatal antiretroviral therapy coverage at > 95% is reported. From June 2018 to March 2019, implementation of routine point-of-care (PoC) maternal HIV VL and early infant diagnosis testing was done at 3 TOUs in Johannesburg and 1 in Tshwane district. They identified 8,147 live births to WLHIV; among these, valid PoC results were evident for 2,769 (34.0%) women and 4,333 (53.2%) neonates. Although antiretroviral therapy coverage was high, a VL ≥ 50 copies/mL at delivery was observed in > 1/3 of WLHIV. Maternal VL ≥ 50 copies/mL accounted for 31/34 (91%) IU infections among mother–neonate pairs. Findings emphasize improving the quality of HIV care among WLHIV for achieving elimination of mother-to-child transmission in South Africa.
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