NEW EPISODE #ScienceinContext! This week, @eonore.bsky.social is joined by @mkwalters3.bsky.social to speak about HIV, vertical transmission, the impact of starting ART before & during pregnancy, and the importance of testing & treatment throughout pregnancy and breastfeeding 👇
youtu.be/xEEWT2QYkf0
Our paper was accompanied by a great commentary from Marcel Yotebieng on the implications of these results on ending paediatric HIV. Check it out here! www.thelancet.com/journals/lan...
These new estimates were incorporated by @unaids.org for the most recent estimation round and result in higher estimates of paediatric HIV. Estimates of infections during breastfeeding were higher, which has implications for infant HIV testing programmes.
Women on INSTI-based regimens (including DTG) had lower odds of transmission and higher odds of viral suppression by delivery than women receiving NNRTI-based regimens.
Most of these studies took place in high-income regions and our study emphasizes the need for more data from diverse regions.
Like previous studies we found that transmission:
Women not on ART > Women using short-course ARVs > Women on ART > Women who start ART before pregnancy
Each additional week a woman was on ART before delivery reduced the odds of 5.6%!
We screened over 400 full-texts and found 24 studies published since the start of 2018 (when these estimates were last updated).
We combined these with 86 studies that had been previously identified to estimate the probability of HIV transmission using four meta-regression models.
Our work built on previous systematic reviews to estimate the probability that a mother living with HIV transmits HIV to their child.
We aimed to quantify changes in this probability that were due to:
1.) Changing service delivery models
2.) Introduction of dolutegravir (DTG) as a first line ART
Very excited to have this out! Was a pleasure to work on this with collaborators from @imperialsph.bsky.social, @ccdd-hsph.bsky.social, @ihmeuw.bsky.social and others across UW, @unaids.org, and others!
Findings threaded below!
Excited to share this preprint as an inaugural bluesky post!
🔑 findings:
-Perinatal vertical HIV transmission (VT) probability is lowest (~0.33%) and viral suppression is highest among women who are on ART before pregnancy
-Women on INSTI regimens have lower risk of VT than women on NNRTIs