Dataset Information

A Nomogram for Predicting Non-Rebound in HBV-Infected Pregnant Women With Mother-to-Child Transmission Prevention.

ABSTRACT: Background: Current guidelines recommend that pregnancies with mother-to-child transmission (MTCT) prevention can cease antiviral treatment after delivery. We aimed to develop a nomogram for predicting non-rebound in HBV-infected pregnant women with MTCT prevention after post-partum nucleos(t)ide analogs (NAs) withdrawal based on parameters before treatment cessation. Methods: Pregnant women receiving antiviral therapy for MTCT prevention and who withdrew from taking NAs after delivery were included in this study. We used the least absolute shrinkage and selection operator (LASSO) logistics and a two-way stepwise regression to select prognostic factors for the risk model, and the concordance index (C-index) was used to assess its discrimination. Internal validation was performed through bootstrapping. Results: Of 92 included patients, 16 and 76 experienced non-rebound and virologic rebound within 48 weeks of post-partum NAs cessation, respectively. Platelet to lymphocyte ratio (PLR) at 34 ± 2 weeks of gestation, a reduction in hepatitis B surface antigen (HBsAg) from baseline to 34 ± 2 weeks of gestation, and hepatitis B virus (HBV) DNA declining from baseline to the end of treatment (EOT) were entered into the final risk model. Its C-index was 0.91 (95% CI, 0.82-0.99), and it reached as high as 0.88 after bootstrapping validation. The decision curve and decision tree were further developed to facilitate the application of this model. Conclusions: We developed a nomogram for predicting non-rebound in pregnant women with MTCT prevention after the withdrawal of antiviral agents, which facilitates physicians in making appropriate treatment recommendations.

SUBMITTER: Wang CR

PROVIDER: S-EPMC8596549 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ObjectiveThe aim of this study was to assess HIV screening for prevention of mother-to-child transmission service utilization and associated factors among pregnant women in Hadiya zone, Southern Ethiopia.MethodsThe study was conducted in a community setting and was cross-sectional with a multistage sampling technique. A total of 613 women were selected randomly from 29 kebeles (the smallest administrative unit next to the district). Data were collected using a standardized interviewer-administered questionnaire. After being coded, reviewed, and entered into Epi-data, the data were exported to SPSS Version 21. Frequencies, percentages, graphs, and means and standard deviations were used to show descriptive data. In bivariate analysis, a p-value of 0.25 was utilized to identify candidate variables for multivariable logistic regression analysis. The statistical significance level was established at 0.05, and the strength of the association was measured using an adjusted odds ratio.ResultsA total of 613 pregnant women out of 630 who were eligible, were included in our study. Among them, 276 (45%; 95% CI: 41.1-48.8) were tested for HIV. HIV screening was associated with secondary and higher maternal educational level (AOR = 5.01, 95% CI: (3.08-8.16)), number of antenatal care visits four and higher (AOR = 4.25, 95% CI: 2.41-7.51), distance from health facility (AOR = 1.93, 95% CI: 1.24-3.101), and male partner involvement (AOR = 1.88, 95% CI: 1.31-2.69).ConclusionLess than half of the pregnant women included in our study had been tested for HIV; which was quite lower than the national requirement that every pregnant woman be tested during a visit. Only those who had a higher level of education, who regularly took antenatal care, who were not far away from the health facility, and whose partner was involved in antenatal care, were more susceptible to being tested. Thus, actions such as female education and increasing accessibility of the service should be prioritized.

Project description:ObjectivesDespite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.DesignA retrospective cross-sectional study in December 2017.SettingAll health facilities providing PMTCT programmes in Indonesia.ParticipantsAll health facilities registering at least one woman in antenatal care in 2017.InterventionPMTCT data extraction from the national reporting system on HIV/AIDS and government reports.OutcomesWomen retention in the PMTCT programme for at least 3 months and associated health facility characteristics.ResultsA total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).ConclusionsWe observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women's retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.

Dataset Information

A Nomogram for Predicting Non-Rebound in HBV-Infected Pregnant Women With Mother-to-Child Transmission Prevention.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets