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Clinical and virologic characteristics post HIV-1 infection

Virologic and immunologic response following antiretroviral therapy initiation among pregnant and postpartum women with acute HIV-1 infection: MOPDB0101.

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Clinical and virologic characteristics post HIV-1 infection

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  1. Virologic and immunologic response following antiretroviral therapy initiation among pregnant and postpartum women with acute HIV-1 infection: MOPDB0101 Alison L. Drake1, John Kinuthia7, Daniel Matemo7, R. Scott McClelland1,2,3, Barbra Richardson4, Julie Overbaugh6, Grace John-Stewart1,2,3,5 Departments of Global Health1, Medicine2, Epidemiology3, Biostatistics4, and Pediatrics5, University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Human Biology, Seattle, WA6 ; Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya7No conflicts of interest to disclose Acknowledgements: Mama Salama Study participants and study staff, the Kenyan Ministry of Health, CDC/KEMRI, and the Ahero and Bondo District Hospitals Fundingprovided by NIH P01 HSD 064915 and CFAR P30 AI27757

  2. Objectiveand population: Characterize virologicand immunologic responses among HIV-1 infected women with acute HIV-1 in pregnancy or postpartum initiating ART Study design and site: Prospective cohort study; Western Kenya Laboratory methods: Serial HIV-1 RNA nucleic acid amplification tests (NAATS); CD4 Statistical methods: Linear mixed effects models to measure changes in HIV-1 RNA • HIV-1 incidence 1.9% (25/1304); incidence rate 2.35 per 100 PY • 12 (48%) infections detected during pregnancy Clinical and virologic characteristics post HIV-1 infection *< 2.17 log10 copies/mL (150 copies/mL)

  3. HIV-1 RNA levels post-ART initiation HIV-1 RNA levels by pregnancy status* -0.62 -0.2 Monthly rate of change** * Among 18 women with ≥2 plasma samples ** Infected during pregnancy vs. infected postpartum; p=0.06 Lower limit of detection • HIV-1 RNA levels ~0.4 log10 higher in acute infection compared to other chronically infected cohorts • ART acceptable, resulted in rapid viral decline • Prompt ART in acute infection important for PMTCT • Long-term follow-up needed to assess durability of viral suppression Conclusions

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