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Reviews of "Antiretroviral Therapy Retention, Adherence, and Clinical Outcomes among Postpartum Women with HIV in Nigeria"

Reviewers: S Vermund (Yale) | 📒📒📒 ◻️◻️ • G Wagner (Pardee RAND Graduate School) | 📗📗📗📗◻️ • D Hoos (Columbia) | 📗📗📗📗◻️ • J Levison (Baylor College of Medicine) | 📒📒📒 ◻️◻️

Published onMay 26, 2024
Reviews of "Antiretroviral Therapy Retention, Adherence, and Clinical Outcomes among Postpartum Women with HIV in Nigeria"
key-enterThis Pub is a Review of
Antiretroviral therapy retention, adherence, and clinical outcomes among postpartum women with HIV in Nigeria
Antiretroviral therapy retention, adherence, and clinical outcomes among postpartum women with HIV in Nigeria
Description

Abstract While research involving pregnant women with HIV has largely focused on the antepartum and intrapartum periods, few studies in Nigeria have examined the clinical outcomes of these women postpartum. This study aimed to evaluate antiretroviral therapy retention, adherence, and viral suppression among postpartum women in Nigeria. This retrospective clinical data analysis included women with a delivery record at the antenatal HIV clinic at Jos University Teaching Hospital between 2013 and 2017. Descriptive statistics quantified proportions retained, adherent (≥95% medication possession ratio), and virally suppressed up to 24 months postpartum. Among 1535 included women, 1497 met the triple antiretroviral therapy eligibility criteria. At 24 months, 1342 (89.6%) women remained in care, 51 (3.4%) reported transferring, and 104 (7.0%) were lost to follow-up. The proportion of patients with ≥95% medication possession ratio decreased from 79.0% to 69.1% over the 24 months. Viral suppression among those with results was 88.7% at 24 months, but <62% of those retained had viral load results at each time point. In multiple logistic regression, predictors of loss to follow-up included having a more recent HIV diagnosis, higher gravidity, fewer antenatal care visits, and a non-hospital delivery. Predictors of viral non-suppression included poorer adherence, unsuppressed/missing baseline viral load, lower baseline CD4+ T-cell count, and higher gravidity. Loss to follow-up rates were lower and antiretroviral therapy adherence rates similar among postpartum women at our study hospital compared with other sub-Saharan countries. Longer follow-up time and inclusion of multiple facilities for a nationally representative sample would be beneficial in future studies.

To read the original manuscript, click the link above.

Summary of Reviews: This preprint is a retrospective cohort study that evaluated antiretroviral therapy retention, adherence, and viral suppression among postpartum women in Nigeria. At two years, 1342 (89.6%) women remained in care, and the proportion of patients with ≥95% medication possession ratio (their adherence measure) decreased from 79.0% to 69.1% over the study period. Viral suppression among those with results was 88.7% at 24 months. Predictors of loss to follow-up included having a more recent HIV diagnosis, higher gravidity, fewer antenatal care visits, and a non-hospital delivery. Reviewers point out the relevance of the study, and only make minor comments mainly about missing data.

Reviewer 1 (Stern V…) | 📒📒📒 ◻️◻️

Reviewer 2 (Glenn W…) | 📗📗📗📗◻️

Reviewer 3 (David H…) | 📗📗📗📗◻️

Reviewer 4 (Judy L…) | 📒📒📒 ◻️◻️

RR:C19 Strength of Evidence Scale Key

📕 ◻️◻️◻️◻️ = Misleading

📙📙 ◻️◻️◻️ = Not Informative

📒📒📒 ◻️◻️ = Potentially Informative

📗📗📗📗◻️ = Reliable

📘📘📘📘📘 = Strong

To read the reviews, click the links below. 

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