Use este identificador para citar ou linkar para este item:
https://www.arca.fiocruz.br/handle/icict/15800
Tipo de documento
ArtigoDireito Autoral
Acesso restrito
Data de embargo
2030-01-01
Coleções
- INI - Artigos de Periódicos [3460]
- IOC - Artigos de Periódicos [12642]
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ANTIRETROVIRAL ADHERENCE DURING PREGNANCY AND POSTPARTUM IN LATIN AMERICA
Autor(es)
Afiliação
Irmandade da Santa Casa de Misericórdia de Porto Alegre. Porto Alegre, RS, Brasil.
Westat. Rockville, Maryland, USA.
Massachusetts General Hospital. Boston, Massachusetts, USA.
Hospital General de Agudos Juan A. Fernandez. Buenos Aires, Argentina.
Hospital General de Agudos Jose Maria Ramos Mejia. Buenos Aires, Argentina.
Hospital Femina. Grupo Hospitalar Conceição. Porto Alegre, RS, Brasil.
Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Univesidade Federal do Rio de Janeiro. Departamento de Medicina Preventiva. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil.
Eunice Kennedy Shriver National Institute of Child Health and Human Development. Pediatric, Adolescent, and Maternal AIDS Branch. Bethesda, Maryland, USA.
Westat. Rockville, Maryland, USA.
Massachusetts General Hospital. Boston, Massachusetts, USA.
Hospital General de Agudos Juan A. Fernandez. Buenos Aires, Argentina.
Hospital General de Agudos Jose Maria Ramos Mejia. Buenos Aires, Argentina.
Hospital Femina. Grupo Hospitalar Conceição. Porto Alegre, RS, Brasil.
Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Univesidade Federal do Rio de Janeiro. Departamento de Medicina Preventiva. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil.
Eunice Kennedy Shriver National Institute of Child Health and Human Development. Pediatric, Adolescent, and Maternal AIDS Branch. Bethesda, Maryland, USA.
Resumo em Inglês
Adherence to antiretrovirals by pregnant women (and postpartum women if breastfeeding) is crucial to effectively decrease maternal viral load and decrease the risk of mother-to-child transmission of HIV. Our objectives were to describe self-reported adherence to antiretrovirals during the antepartum (after 22 weeks of pregnancy) and postpartum periods (6-12 weeks and 6 months), and identify predictors of adherence among HIV-infected women enrolled and followed in a prospective cohort study from June 2008 to June 2010 at multiple sites in Latin America. Adherence was evaluated using the number of missed and expected doses during the 3 days before the study visit. At the pre-delivery visit, 340 of 376 women (90%) reported perfect adherence. This rate significantly decreased by 6-12 weeks (171/214 [80%]) and 6 months postpartum (163/199 [82%], p<0.01). The odds for less than perfect adherence at the pre-delivery visit was significantly higher for pregnant women with current tobacco use (odds ratio [OR]=2.9, 95% confidence interval [CI]: 1.46-6.14; p=0.0029). At 6-12 weeks postpartum, the probability of non-perfect adherence increased by 6% for each 1 year increase in age (OR=1.06, 95% CI: 1.00-1.12, p=0.0497). At 6 months postpartum, the odds of nonperfect adherence was higher for those who were currently using alcohol (OR=3.04, 95% CI: 1.34-6.90; p=0.0079). Although a self-report measure of adherence based on only 3 days may lead to overestimation of actual adherence over time, women with perfect adherence had lower viral loads and higher CD4 counts. Adherence to antiretrovirals decreased significantly postpartum. Interventions should target women at high risk for lower adherence during pregnancy and postpartum, including tobacco and alcohol users.
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