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Finding
Finding
improvement
Among SDNVP-exposed women initiating NNRTI-based ART, the proportion achieving viral suppression increased significantly with longer time since SDNVP exposure, from 37.5% at <6 months to 77.1% at >24 months, with attenuation of efficacy persisting to 12 months post-exposure.
| Effect size | chi-square trend p=0.01 |
| Follow-up | 6 months |
| Comparator | Women starting ART <6 months after SDNVP (lowest suppression rate, 37.5%) |
| Effect summary | improvement; chi-square trend p=0.01 |
| Effect modifiers | [{"modifier": "Baseline viral load during pregnancy (>=100,000 vs <100,000 copies/ml)", "interaction_p": "p=0.09", "direction": "amplifies", "stratum_details": "VL >=100,000: SDNVP <=12mo 35.3% suppressed vs >12mo 72.9% suppressed (p=0.006). VL <100,000: SDNVP <=12mo 75.0% suppressed vs >12mo 75.9% suppressed (p>0.1)", "plain_language": "Women with high viral load during the pregnancy when they got nevirapine were much more affected by the timing -- waiting longer mattered a lot more for them. Women with lower viral load did equally well regardless of timing.", "annotation_notes": "Formal interaction term p=0.09 (not significant), but the stratified analysis shows a dramatic difference in the SDNVP-timing effect. Among high-VL women, the gradient is steep (35.3% vs 72.9%). Among low-VL women, there is no gradient at all (75.0% vs 75.9%)."}, {"modifier": "Employment status", "interaction_p": "", "direction": "attenuates", "stratum_details": "Employed 57.1% suppressed vs unemployed 78.1% suppressed (p=0.005)", "plain_language": "Women with jobs were less likely to achieve viral suppression, possibly because inflexible working hours interfered with healthcare access.", "annotation_notes": "Authors hypothesize this reflects healthcare access barriers (inflexible work hours, low-paying jobs) rather than a biological modifier. The SDNVP-timing association persisted after adjusting for employment status."}, {"modifier": "HIV transmission to child (transmitter vs non-transmitter)", "interaction_p": "", "direction": "attenuates", "stratum_details": "Non-transmitter 76.9% suppressed vs transmitter (child infected) 59.7% suppressed (p=0.02)", "plain_language": "Mothers who transmitted HIV to their baby during birth were less likely to suppress the virus on treatment, possibly reflecting more aggressive viral characteristics.", "annotation_notes": "Authors hypothesize viral pathogenicity not fully accounted for by viral load and CD4 count. The SDNVP-timing association persisted after adjusting for transmission status."}] |
Connected entities
Interventions
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Outcomes
Populations
Source
PMC2782481
Mortality and virologic outcomes following access to antiretroviral therapy among a cohort of HIV-infected women who received single-dose nevirapine in Lusaka, Zambia