TY - JOUR
T1 - Levels and patterns of HIV RNA viral load in untreated pregnant women
AU - NN, NN
AU - Patel, Deven
AU - Thorne, Claire
AU - Newell, Marie-Louise
AU - Cortina-Borja, Mario
AU - Valerius, Niels Henrik
PY - 2008
Y1 - 2008
N2 - OBJECTIVE: To assess pregnancy levels and patterns of HIV RNA in the absence of antiretroviral therapy, while appropriately adjusting for potential confounders, including maternal immune status and race. METHODS: Data on > or = 1 antenatal HIV RNA measurements were available for 333 untreated HIV-infected pregnant women enrolled in the European Collaborative Study. CD4 counts and HIV RNA measurements were routinely collected from 1992 and 1998, respectively. Linear mixed effects models based on 246 women for whom complete data were available examined changes in HIV RNA levels over pregnancy, with a nested random effects term accounting for measurement variability within women and period of sample collection. RESULTS: The change in HIV RNA over pregnancy varied significantly by race (p=0.005): from the second trimester until delivery, HIV RNA decreased significantly by an estimated 0.019 log(10) copies/ml/week in white women (95% CI -0.03, -0.007); in black women the estimated 0.016 log(10) copies/ml/week increase (95% CI -0.005, 0.037) was not statistically significant. At delivery, HIV RNA levels in black women were 0.45 log(10) copies/ml higher (95% CI 0.08, 0.83) than in white women. CONCLUSIONS: Our findings suggest that HIV RNA dynamics over pregnancy differ by race, although other interpretations cannot be excluded, due to potential for unmeasured confounding.
AB - OBJECTIVE: To assess pregnancy levels and patterns of HIV RNA in the absence of antiretroviral therapy, while appropriately adjusting for potential confounders, including maternal immune status and race. METHODS: Data on > or = 1 antenatal HIV RNA measurements were available for 333 untreated HIV-infected pregnant women enrolled in the European Collaborative Study. CD4 counts and HIV RNA measurements were routinely collected from 1992 and 1998, respectively. Linear mixed effects models based on 246 women for whom complete data were available examined changes in HIV RNA levels over pregnancy, with a nested random effects term accounting for measurement variability within women and period of sample collection. RESULTS: The change in HIV RNA over pregnancy varied significantly by race (p=0.005): from the second trimester until delivery, HIV RNA decreased significantly by an estimated 0.019 log(10) copies/ml/week in white women (95% CI -0.03, -0.007); in black women the estimated 0.016 log(10) copies/ml/week increase (95% CI -0.005, 0.037) was not statistically significant. At delivery, HIV RNA levels in black women were 0.45 log(10) copies/ml higher (95% CI 0.08, 0.83) than in white women. CONCLUSIONS: Our findings suggest that HIV RNA dynamics over pregnancy differ by race, although other interpretations cannot be excluded, due to potential for unmeasured confounding.
KW - Adolescent
KW - Adult
KW - African Continental Ancestry Group
KW - Asian Continental Ancestry Group
KW - CD4 Lymphocyte Count
KW - European Continental Ancestry Group
KW - Female
KW - Gestational Age
KW - HIV Infections
KW - HIV-1
KW - Humans
KW - Pregnancy
KW - Pregnancy Complications, Infectious
KW - RNA, Viral
KW - Viral Load
KW - Young Adult
U2 - 10.1016/j.ijid.2008.07.004
DO - 10.1016/j.ijid.2008.07.004
M3 - Journal article
C2 - 18929501
SN - 1878-3511
VL - 13
SP - 266
EP - 273
JO - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
IS - 2
ER -