Maternal Immunologic and Clinical Response to Antiretroviral Therapy Initiation Before or During Pregnancy in HIV-1 Infected Women and associated factors in Southwest Ethiopia

Abstract

SUMMARY The aim of this study is to assess maternal treatment outcomes to antiretroviral therapy initiated before or during pregnancy in HIV-1 infected women and associated factors in southwest Ethiopia. Hospital based retrospective cohort study was conducted from January 1st 2008 to December 31st 2012.The data were processed using SPSS version 16 (Chicago: SPSS Inc., 2007). A p-value of < 0.05 was considered statistically significant. Among the 202 study participants, 169(83.6%) and 142(70.3%) had good immunological and clinical outcomes respectively. In adjusted logistic regression analysis, unknown HIV status prior to pregnancy (AOR=0.158, 95% CI=(0.041–0.602), P=0.007), Baseline CD4 count < 200 (AOR = 0.023, 95%CI= (0.003–0.190), P=0.000), baseline WHO clinical stage III (AOR=7.673, 95%CI=1.640–35.892, P=0.010), Highly Active Antiretroviral Therapy initiation during pregnancy (AOR=0.349,95% CI=0.157–0.776,P=0.010) were identified as independent predictors of maternal treatment outcomes. In conclusion, Women who started Highly Active Antiretroviral Therapy before pregnancy had good clinical outcome compared to those who started during pregnancy. The independent predictors of maternal outcomes were HIV status prior to pregnancy, baseline CD4 count before initiation of Highly Active Antiretroviral Therapy, time of Highly Active Antiretroviral Therapy initiation, world health organization clinical stage before initiation of Highly Active Antiretroviral Therapy and duration of treatment with Highly Active Antiretroviral Therapy.