Study Examines Postpartum Risk of Viremia Among HIV-Infected Women

A recent study found that viremia occurs frequently in HIV-infected women who initiate antiretroviral therapy (ART) during pregnancy.

The study included 523 women who initiated ART during pregnancy (300 mg of tenofovir, 200 mg emtricitabine, and 600 mg efavirenz once daily) and achieved viral suppression. From pregnancy through 12 months after childbirth, participants provided specimens for batched viral load testing. Analyses described the incidence of major and minor viremic episodes (VE), and factors associated with major VE. Median follow-up from viral suppression was 322 days.
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Viral suppression was maintained in 70% of participants through follow-up, at least 1 major viral episode was documented in 22% of women, and 8% experienced only minor VEs.

Researchers found that peak viremia in women with VE was linearly related to pre-ART viral load. In addition, the incidence of major VE was independently associated with younger age, ART initiation during the third trimester, previous default on ART, and post-partum follow-up.

“Viremia appears to occur frequently, particularly postpartum, among HIV-infected women after initial [viral suppression] in this setting. More intensive VL monitoring is warranted in this population; the immediate causes and long-term implications of VE require investigation,” the researchers concluded.

—Melissa Weiss

Reference:

Myer L, Dunning L, Lesosky M, et al. Frequency of viremic episodes in HIV-infected women initiating antiretroviral therapy during pregnancy: a cohort study [published online January 17, 2017]. Clinical Infectious Disease. doi: doi.org/10.1093/cid/ciw792.