Resum
Purpose: To identify factors associated with virologic failure (VF) in women with HIV, patients of two clinics in Mexico City.
Method: An observational cross-sectional study. Carried out among women patients at the Condesa Clinics between January 2014 and December 2018. All patients were pregnant (Cohort pregnant women) and had been undergoing HAART (highly active antiretroviral treatment) for at least six months and possessed complete medical records. Convenience sampling, prevalence, odds ratio, chi2 and attributable risk were analyzed using SPSS24.
Results: 169 women with HIV from the Condesa Specialized Clinic (CSC)and CSC-Iztapalapa.143 in statistical analysis, 15% (n=16)failed to follow up. Median age, 28 years(SD 6.1). Education: 47% completed middle school. Unpaid employment: 78%. 74% have a stable partner. 85% with virologic suppression and 15% with virologic failure(VF). Women with chronic HIV(n=67), 41% with VF at the time of first medical consultation in pregnancy: VL 16,355 copies/mL(SD 261891 c/mL), at the third quarter before birth 97% with VL< 200c/mL, at present 85% VL< 200c/mL. CD4(cells/mm3): 381c/mm3(SD 224), 432 c/mm3(SD 185) and 427 c/mm3 SD 241) respectively. 61% serodiscordant couples. Women with recent diagnosis of HIV(pregnancy scrutiny, n=76) first viral load 22,106c/ml (SD 41285 c/ml), before birth 95% with VL< 1000 c/ml, at present 95% VL< 200 c/ml, 5% in VF. CD4(cells/mm3): 302 c/mm3(SD 214), 375 c/mm3(SD 257) and 581 c/mm3(SD 332) respectively; 47% concordant couples. In both, the probability of VF in women who experienced domestic violence was 3.1 OR(SD 1.3-9.9, p 0.01) and in those receiving antiretroviral treatment with protease inhibitor (PI) the probability of VF was 2.9 OR(SD 1.1-7.5, p 0.03).
Conclusion: In this study we observed two factors associated with VF; identifying the associated factors is useful in developing intervention strategies. If we eliminated domestic violence, the VF decreases 73% and if we change HAART without PI, VF decreases