{'fraction_non_alphanumeric': 0.03590040532715692, 'fraction_numerical': 0.03242617255356109, 'mean_word_length': 5.23826714801444, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Initiation of antiretroviral therapy among pregnant women in resource-limited countries: CD4+ cell count response and program retention

Objective(s):Few data are available from resource-limited countries on long-term outcomes of HIV-infected women who initiate antiretroviral therapy (ART) during pregnancy. Design:Analysis of data from adult patients enrolled in the MTCT-Plus Initiative who initiated ART between 2003 and 2006 in seven countries in Sub-Saharan Africa and Thailand. Methods:Mean population changes were assessed and multivariable mixed linear regression modeling was used to examine covariate effects on differences in absolute CD4+ cell count responses. Kaplan–Meier methods were used to examine program retention combining survival and losses to follow-up. Results:Of 2229 individuals initiating ART, 1688 were women, of which 605 were pregnant (median gestational age 7 months), 1083 were not pregnant, and 541 were men. The average CD4+ response by 30 months on ART was 451 cells/μl among women who were pregnant at ART initiation as compared with 435 cells/μl among nonpregnant women (P = 0.53) and 349 cells/μl among men (P < 0.001). In multivariable analysis, lower CD4+ cell increase was independently associated with male sex, older age, and lower CD4+ cell count at initiation. After 30 months on ART retention was 0.85 with no retention differences between pregnant women, nonpregnant women, and men. Conclusion:HIV-infected women in resource-limited countries who start ART during pregnancy have similar or better long-term CD4+ cell count responses as compared with other adults. These data support efforts to provide pregnant HIV-infected women with access to ART in resource-limited countries.