PubMed:23825876 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PubMed/sourceid/23825876","sourcedb":"PubMed","sourceid":"23825876","source_url":"http://www.ncbi.nlm.nih.gov/pubmed/23825876","text":"Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine.\nOBJECTIVE: To investigate the scale-up of antenatal combination antiretroviral therapy (cART) in Ukraine since this became part of the national policy for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV).\nMETHODS: Data on 3535 HIV-positive pregnant women who were enrolled into the Ukraine European Collaborative Study in 2008-2010 were analysed. Factors associated with receipt of zidovudine monotherapy (AZTm) - rather than cART - and rates of mother-to-child transmission (MTCT) of HIV were investigated.\nFINDINGS: cART coverage increased significantly, from 22% of deliveries in 2008 to 61% of those in 2010. After adjusting for possible confounders, initiation of antenatal AZTm - rather than cART - was associated with cohabiting (versus being married; adjusted prevalence ratio, aPR: 1.09; 95% confidence interval, CI: 1.02-1.16), at least two previous live births (versus none; aPR: 1.22; 95% CI: 1.11-1.35) and a diagnosis of HIV infection during the first or second trimester (versus before pregnancy; aPR: 1.11; 95% CI: 1.03-1.20). The overall MTCT rate was 4.1% (95% CI: 3.4-4.9); 42% (49/116) of the transmissions were from the 8% (n = 238) of women without antenatal ART. Compared with AZTm, cART was associated with a 70% greater reduction in the risk of MTCT (adjusted odds ratio: 0.30; 95% CI: 0.16-0.56).\nCONCLUSION: Between 2008 and 2010, access to antenatal cART improved substantially in Ukraine, but implementation of the World Health Organization's Option-B policy was slow. For MTCT to be eliminated in Ukraine, improvements in the retention of women in HIV care and further roll-out of Option B are urgently needed.","tracks":[{"project":"Allie","denotations":[{"id":"SS1_23825876_2_0","span":{"begin":170,"end":204},"obj":"expanded"},{"id":"SS2_23825876_2_0","span":{"begin":206,"end":210},"obj":"abbr"},{"id":"SS1_23825876_2_1","span":{"begin":277,"end":319},"obj":"expanded"},{"id":"SS2_23825876_2_1","span":{"begin":321,"end":326},"obj":"abbr"},{"id":"SS1_23825876_2_2","span":{"begin":331,"end":359},"obj":"expanded"},{"id":"SS2_23825876_2_2","span":{"begin":361,"end":364},"obj":"abbr"},{"id":"SS1_23825876_5_0","span":{"begin":517,"end":566},"obj":"expanded"},{"id":"SS2_23825876_5_0","span":{"begin":568,"end":572},"obj":"abbr"},{"id":"SS1_23825876_5_1","span":{"begin":608,"end":636},"obj":"expanded"},{"id":"SS2_23825876_5_1","span":{"begin":638,"end":642},"obj":"abbr"}],"relations":[{"id":"AE1_23825876_2_0","pred":"abbreviatedTo","subj":"SS1_23825876_2_0","obj":"SS2_23825876_2_0"},{"id":"AE1_23825876_2_1","pred":"abbreviatedTo","subj":"SS1_23825876_2_1","obj":"SS2_23825876_2_1"},{"id":"AE1_23825876_2_2","pred":"abbreviatedTo","subj":"SS1_23825876_2_2","obj":"SS2_23825876_2_2"},{"id":"AE1_23825876_5_0","pred":"abbreviatedTo","subj":"SS1_23825876_5_0","obj":"SS2_23825876_5_0"},{"id":"AE1_23825876_5_1","pred":"abbreviatedTo","subj":"SS1_23825876_5_1","obj":"SS2_23825876_5_1"}],"attributes":[{"subj":"SS1_23825876_2_0","pred":"source","obj":"Allie"},{"subj":"SS2_23825876_2_0","pred":"source","obj":"Allie"},{"subj":"SS1_23825876_2_1","pred":"source","obj":"Allie"},{"subj":"SS2_23825876_2_1","pred":"source","obj":"Allie"},{"subj":"SS1_23825876_2_2","pred":"source","obj":"Allie"},{"subj":"SS2_23825876_2_2","pred":"source","obj":"Allie"},{"subj":"SS1_23825876_5_0","pred":"source","obj":"Allie"},{"subj":"SS2_23825876_5_0","pred":"source","obj":"Allie"},{"subj":"SS1_23825876_5_1","pred":"source","obj":"Allie"},{"subj":"SS2_23825876_5_1","pred":"source","obj":"Allie"}]},{"project":"PubmedHPO","denotations":[{"id":"T1","span":{"begin":337,"end":353},"obj":"HP_0002721"}],"attributes":[{"subj":"T1","pred":"source","obj":"PubmedHPO"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"Allie","color":"#d993ec","default":true},{"id":"PubmedHPO","color":"#93ecbf"}]}]}}