Women with HIV: viral load after childbirth
As of 2018, HIV-infected women with undetectable viral load can breastfeed in Switzerland if they wish. In these cases, postnatal monitoring is essential. However, despite a suppressed viral load at delivery, several studies have reported low adherence to HIV monitoring and insufficiently suppressed viral load after delivery.
We analyzed births of women with HIV and undetectable viral load in the Swiss HIV Cohort Study (SHCS) between January 2000 and December 2018. We analyzed whether the mother and baby were followed in the first 12 months after birth and whether viral load remained suppressed during this period.
Overall, 94% (694 of 737) of women with HIV remained on care for at least six months after birth. Late initiation of combination antiretroviral therapy (cART) during the third trimester was found to be the main risk factor for discontinuation of follow-up care. Among mothers who received cART until at least one year after delivery, 4.4 percent (26 of 591) had a detectable viral load, with drug use as the most important risk factor. The major risk factor for noncompliance with newborn follow-up recommendations was maternal depression.
Although the high rate of correct postnatal follow-up of mother and infant is reassuring overall, several modifiable risk factors for failure to follow-up were identified, such as delayed initiation of treatment and maternal depression. These factors should be considered in the treatment of all women with HIV, especially those who choose to breastfeed in our country.
Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study, The Lancet Regional Health – Europe, 16.11.2023, DOI: 10.1016/j.lanepe.2023.100656.
Swiss HIV Cohort Study (SHCS)
What is a cohort study?
A cohort is a group of people who have experienced a common, long-term formative event. The HIV cohort study includes people with HIV in Switzerland.
What does the SHCS do?
The SHCS is a collaboration between hospitals and treating physicians who care for people with HIV. Since 1988, the SHCS has followed over 22,000 people with HIV, collected their health data and analysed it in scientific studies.
Why collect data?
The aim of research is to improve the quality of life of people living with HIV. Thanks to the research results, treating physicians can improve HIV therapy, for example by reducing side effects. Mental health needs also become more visible. By participating in the SHCS, people with HIV make a valuable contribution to improving medical care - for themselves and others.