Please use this identifier to cite or link to this item: http://ir.mu.ac.ke:8080/jspui/handle/123456789/4927
Title: Hormonal contraceptive use and risk of HIV-1 disease progression
Authors: Heffron, Renee
Mugo, Nelly
Ngure, Kenneth
Celum, Connie
Donnell, Deborah
Were, Edwin
Rees, Helen
Kiarie, James
Baeten, Jared M.
Keywords: Hormonal contraception
Antiretroviral therapy
HIV-1 progression
Issue Date: 2013
Publisher: NIH Public Access
Abstract: Background: For HIV-1-infected women, hormonal contraception prevents unintended pregnancy, excess maternal morbidity, and vertical HIV-1 transmission. Hormonal contraceptives are widely used but their effects on HIV-1 disease progression are unclear. Methods: In a prospective study among 2269 chronically HIV-1-infected women from seven countries in eastern and southern Africa and with enrollment CD4 cell counts at least 250 cells/μl, we compared rates of HIV-1 disease progression among those using and not using hormonal contraception (i.e. oral or injectable methods). The primary outcome was a composite endpoint of CD4 decline to less than 200 cells/μl, initiation of antiretroviral therapy, or death. Results: Three hundred and seventy-two women experienced HIV-1 disease progression during 3242 years of follow-up (incidence rate = 11.5 events per 100 person-years). Rates of HIV-1 disease progression among women who were currently using and not using hormonal contraception were 8.54 and 12.31 per 100 person-years, respectively (adjusted hazard ratio 0.74, 95% confidence interval 0.56–0.98, P = 0.04). Rates were 8.58 and 8.39 per 100 person-years for the subsets using injectable and oral contraception (adjusted hazard ratio = 0.72, P = 0.04 for injectable users and adjusted hazard ratio = 0.83, P = 0.5 for oral users compared to women not using hormonal contraception). Sensitivity analyses assessing enrollment or cumulative contraceptive use during the study demonstrated risk estimates closer to 1.0 with no evidence for accelerated disease progression. Conclusion: Among African women with chronic HIV-1 infection, use of hormonal contraception was not associated with deleterious consequences for HIV-1 disease progression.
URI: http://dx.doi.org/10.1097/QAD.0b013e32835ad473
http://ir.mu.ac.ke:8080/jspui/handle/123456789/4927
Appears in Collections:School of Medicine

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