1498. Pregnant Women Present with Viral Loads Under One-half that of Non-pregnant Women at HIV Diagnosis
Session: Poster Abstract Session: HIV and Pregnancy
Friday, October 28, 2016
Room: Poster Hall
  • pregnancy and vl poster poster .pdf (288.1 kB)
  • Background: In 2015 a Michigan physician observed unusually low viral loads (VL) among antiretroviral therapy (ARV) naïve pregnant women newly diagnosed with HIV. The objective of this study was to compare differences in HIV VL among newly diagnosed pregnant and non-pregnant women residing in three US states.

    Methods: A retrospective cohort analysis of ARV naïve, 15-49 year old females, diagnosed between 2006-2015 with an estimated time between infection and diagnosis was conducted. Data were from the CDC distributed enhanced HIV/AIDS Reporting Systems (eHARS) of Michigan, New York and Virginia. eHARS is used to collect, manage and report HIV-infection case surveillance data to CDC. Comprehensive and consistent laboratory reporting of HIV-related test results is mandated in all three states. Multivariable regression models evaluated the relationship between log VL at diagnosis and pregnancy status at diagnosis after accounting for time since HIV infection, trimester of diagnosis, race/ethnicity, and age at diagnosis.

    Results: A total of 5,034 women with newly diagnosed HIV from Michigan (n=781), New York (n=3,545) and Virginia (n=708) met inclusion criteria. Of these, 650 (12.91%) pregnant women were identified. Pregnant women were diagnosed significantly earlier in their infection in all three states (p<0.0001). Holding this and other aforementioned factors constant, pregnancy was significantly associated with lower viral loads at diagnosis (Michigan, p=0.0128; Virginia, p=0.0157; New York state, p=0.0002).

    Conclusion: Pregnant women in three US states had significantly lower HIV viral loads at diagnosis compared to their non-pregnant counterparts after controlling for time since HIV infection, trimester, race/ethnicity and age. This association has not been addressed in published literature and could lead to further studies to determine if viral load affects fertility or if pregnancy affects viral load levels.

    Figure 1. Time since HIV diagnosis is a CDC defined algorithm accounting for BED Assays/Bio-Rad Avidity and testing history. “Recently infected” persons are diagnosed within six months of infection. “Not recently infected” persons are not “recently infected” but diagnosed at least six months before progressing to HIV stage 3.

    Mary-Grace Brandt, PHD MPH1, Jennifer Mills, MPH1, Jacob Watson, MPH1, James Sunstrum, MD2, Carol-Ann Swain, MS3 and Bridget Anderson, PHD3, (1)Michigan Department of Health and Human Services, Southfield, MI, (2)Beaumont Health System, Dearborn, MI, (3)New York State Department of Health, Albany, NY


    M. G. Brandt, None

    J. Mills, None

    J. Watson, None

    J. Sunstrum, None

    C. A. Swain, None

    B. Anderson, None

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