What Will It Take to Eliminate Pediatric HIV? Reaching WHO Target Rates of Mother-to-Child HIV Transmission in Zimbabwe: A Model-Based Analysis
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{"title"=>"What will it take to eliminate pediatric HIV? Reaching WHO target rates of mother-to-child HIV transmission in zimbabwe: A model-based analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Andrea L.", "last_name"=>"Ciaranello", "scopus_author_id"=>"6506141936"}, {"first_name"=>"Freddy", "last_name"=>"Perez", "scopus_author_id"=>"55487079700"}, {"first_name"=>"Jo", "last_name"=>"Keatinge", "scopus_author_id"=>"42761502900"}, {"first_name"=>"Ji Eun", "last_name"=>"Park", "scopus_author_id"=>"57196405512"}, {"first_name"=>"Barbara", "last_name"=>"Engelsmann", "scopus_author_id"=>"13608093000"}, {"first_name"=>"Matthews", "last_name"=>"Maruva", "scopus_author_id"=>"39061780800"}, {"first_name"=>"Rochelle P.", "last_name"=>"Walensky", "scopus_author_id"=>"6602540593"}, {"first_name"=>"Francois", "last_name"=>"Dabis", "scopus_author_id"=>"7101905261"}, {"first_name"=>"Jennifer", "last_name"=>"Chu", "scopus_author_id"=>"35226255000"}, {"first_name"=>"Asinath", "last_name"=>"Rusibamayila", "scopus_author_id"=>"55268293800"}, {"first_name"=>"Angela", "last_name"=>"Mushavi", "scopus_author_id"=>"36632730600"}, {"first_name"=>"Kenneth A.", "last_name"=>"Freedberg", "scopus_author_id"=>"7004947755"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"pmid"=>"22253579", "doi"=>"10.1371/journal.pmed.1001156", "sgr"=>"84863031202", "isbn"=>"1549-1277", "scopus"=>"2-s2.0-84863031202", "issn"=>"15491277", "pui"=>"364181051"}, "id"=>"2b9990b4-9e03-3cb0-a07f-e73b35515395", "abstract"=>"BACKGROUND: The World Health Organization (WHO) has called for the \"virtual elimination\" of pediatric HIV: a mother-to-child HIV transmission (MTCT) risk of less than 5%. We investigated uptake of prevention of MTCT (PMTCT) services, infant feeding recommendations, and specific drug regimens necessary to achieve this goal in Zimbabwe.\\n\\nMETHODS AND FINDINGS: We used a computer model to simulate a cohort of HIV-infected, pregnant/breastfeeding women (mean age, 24 y; mean CD4, 451/µl; breastfeeding duration, 12 mo). Three PMTCT regimens were evaluated: (1) single-dose nevirapine (sdNVP), (2) WHO 2010 guidelines' \"Option A\" (zidovudine in pregnancy, infant nevirapine throughout breastfeeding for women without advanced disease, lifelong combination antiretroviral therapy for women with advanced disease), and (3) WHO \"Option B\" (pregnancy/breastfeeding-limited combination antiretroviral drug regimens without advanced disease; lifelong antiretroviral therapy with advanced disease). We examined four levels of PMTCT uptake (proportion of pregnant women accessing and adhering to PMTCT services): reported rates in 2008 and 2009 (36% and 56%, respectively) and target goals in 2008 and 2009 (80% and 95%, respectively). The primary model outcome was MTCT risk at weaning. The 2008 sdNVP-based National PMTCT Program led to a projected 12-mo MTCT risk of 20.3%. Improved uptake in 2009 reduced projected risk to 18.0%. If sdNVP were replaced by more effective regimens, with 2009 (56%) uptake, estimated MTCT risk would be 14.4% (Option A) or 13.4% (Option B). Even with 95% uptake of Option A or B, projected transmission risks (6.1%-7.7%) would exceed the WHO goal of less than 5%. Only if the lowest published transmission risks were used for each drug regimen, or breastfeeding duration were shortened, would MTCT risks at 95% uptake fall below 5%.\\n\\nCONCLUSIONS: Implementation of the WHO PMTCT guidelines must be accompanied by efforts to improve access to PMTCT services, retain women in care, and support medication adherence throughout pregnancy and breastfeeding, to approach the \"virtual elimination\" of pediatric HIV in Zimbabwe. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/it-take-eliminate-pediatric-hiv-reaching-target-rates-mothertochild-hiv-transmission-zimbabwe-modelb-1", "reader_count"=>139, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>5, "Student > Doctoral Student"=>10, "Researcher"=>23, "Student > Ph. D. Student"=>18, "Student > Postgraduate"=>12, "Student > Master"=>36, "Other"=>8, "Student > Bachelor"=>11, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>3, "Professor"=>5}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>5, "Student > Doctoral Student"=>10, "Researcher"=>23, "Student > Ph. D. Student"=>18, "Student > Postgraduate"=>12, "Student > Master"=>36, "Other"=>8, "Student > Bachelor"=>11, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>3, "Professor"=>5}, "reader_count_by_subject_area"=>{"Unspecified"=>8, "Agricultural and Biological Sciences"=>14, "Arts and Humanities"=>1, "Business, Management and Accounting"=>3, "Chemistry"=>1, "Economics, Econometrics and Finance"=>3, "Engineering"=>1, "Environmental Science"=>1, "Nursing and Health Professions"=>7, "Medicine and Dentistry"=>72, "Design"=>1, "Psychology"=>3, "Social Sciences"=>21, "Immunology and Microbiology"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>72}, "Social Sciences"=>{"Social Sciences"=>21}, "Psychology"=>{"Psychology"=>3}, "Unspecified"=>{"Unspecified"=>8}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Design"=>{"Design"=>1}, "Engineering"=>{"Engineering"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>14}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>7}}, "reader_count_by_country"=>{"Canada"=>1, "United States"=>2, "South Africa"=>3, "France"=>1, "Nigeria"=>1, "Spain"=>1}, "group_count"=>14}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/353035"], "description"=>"<div><h3>Background</h3><p>The World Health Organization (WHO) has called for the “virtual elimination” of pediatric HIV: a mother-to-child HIV transmission (MTCT) risk of less than 5%. We investigated uptake of prevention of MTCT (PMTCT) services, infant feeding recommendations, and specific drug regimens necessary to achieve this goal in Zimbabwe.</p> <h3>Methods and Findings</h3><p>We used a computer model to simulate a cohort of HIV-infected, pregnant/breastfeeding women (mean age, 24 y; mean CD4, 451/µl; breastfeeding duration, 12 mo). Three PMTCT regimens were evaluated: (1) single-dose nevirapine (sdNVP), (2) WHO 2010 guidelines' “Option A” (zidovudine in pregnancy, infant nevirapine throughout breastfeeding for women without advanced disease, lifelong combination antiretroviral therapy for women with advanced disease), and (3) WHO “Option B” (pregnancy/breastfeeding-limited combination antiretroviral drug regimens without advanced disease; lifelong antiretroviral therapy with advanced disease). We examined four levels of PMTCT uptake (proportion of pregnant women accessing and adhering to PMTCT services): reported rates in 2008 and 2009 (36% and 56%, respectively) and target goals in 2008 and 2009 (80% and 95%, respectively). The primary model outcome was MTCT risk at weaning.</p> <p>The 2008 sdNVP-based National PMTCT Program led to a projected 12-mo MTCT risk of 20.3%. Improved uptake in 2009 reduced projected risk to 18.0%. If sdNVP were replaced by more effective regimens, with 2009 (56%) uptake, estimated MTCT risk would be 14.4% (Option A) or 13.4% (Option B). Even with 95% uptake of Option A or B, projected transmission risks (6.1%–7.7%) would exceed the WHO goal of less than 5%. Only if the lowest published transmission risks were used for each drug regimen, or breastfeeding duration were shortened, would MTCT risks at 95% uptake fall below 5%.</p> <h3>Conclusions</h3><p>Implementation of the WHO PMTCT guidelines must be accompanied by efforts to improve access to PMTCT services, retain women in care, and support medication adherence throughout pregnancy and breastfeeding, to approach the “virtual elimination” of pediatric HIV in Zimbabwe.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["pediatric", "reaching", "rates", "mother-to-child", "hiv", "model-based"], "article_id"=>129778, "categories"=>["Biotechnology", "Cancer", "Medicine"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/What_Will_It_Take_to_Eliminate_Pediatric_HIV_Reaching_WHO_Target_Rates_of_Mother_to_Child_HIV_Transmission_in_Zimbabwe_A_Model_Based_Analysis/129778", "title"=>"What Will It Take to Eliminate Pediatric HIV? Reaching WHO Target Rates of Mother-to-Child HIV Transmission in Zimbabwe: A Model-Based Analysis", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 02:42:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/693783"], "description"=>"<p>This figure shows the “two dimensions” in which PMTCT services can be improved. First, along the vertical arrow, PMTCT programs can transition to more intensive drug regimens (i.e., from sdNVP to Option A to Option B). Second, along the horizontal arrow, programs can undertake interventions to improve “uptake” of PMTCT services, defined as the proportion of pregnant, HIV-infected women who receive and adhere to ARVs for PMTCT, for example, from 36% in 2008 to 56% in 2009, and perhaps to 80% or 95% with future scale-up effort. Within the horizontal arrow are depicted the three “domains” of uptake examined in these analyses: care and testing, drug availability, or retention. sdNVP represents the current National PMTCT Program, based largely on sdNVP; “Option A” and “Option B” are the WHO 2010 PMTCT guideline-recommended regimens, as defined in the text and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001156#pmed.1001156.s001\" target=\"_blank\">Text S1</a>.</p>", "links"=>[], "tags"=>["dimensions", "improvements", "pmtct"], "article_id"=>364211, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Two_dimensions_for_potential_improvements_in_PMTCT_in_Zimbabwe_/364211", "title"=>"Two dimensions for potential improvements in PMTCT in Zimbabwe.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-01-10 01:10:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/693938"], "description"=>"<p>Tornado diagram summarizing the results of key one-way sensitivity analyses. Model parameters are on the vertical axis. For each parameter, the value used in the base-case analysis is listed in parentheses, followed by the range examined in sensitivity analysis. For example, the “regimen” provided for PMTCT is varied from Option B (lowest MTCT risk with all other parameters held constant), through Option A (base-case MTCT risk), to sdNVP (highest MTCT risk). The horizontal axis represents projected MTCT risk by the time of weaning. The solid vertical line represents transmission risk (14.4%) at the base-case set of parameters: 56% uptake, mean published MTCT risks, 36% of mothers with CD4<350/µl, breastfeeding duration of 12 mo, and the WHO “Option A” regimen. The dashed vertical line represents the 5% MTCT target of “virtual elimination” expressed by international HIV/AIDS agencies including WHO and the Joint United Nations Programme on HIV/AIDS. ARV prophylaxis in the Option A and Option B regimens is assumed to continue throughout the duration of breastfeeding.</p>", "links"=>[], "tags"=>["parameters", "determining", "mtct"], "article_id"=>364359, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Key_parameters_determining_MTCT_risk_/364359", "title"=>"Key parameters determining MTCT risk.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-01-10 01:12:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/694080"], "description"=>"<p>Each horizontal block represents results for a specific drug regimen: sdNVP (top), Option A (middle), and Option B (bottom). Within each block, four levels of uptake are depicted across the top horizontal axis: 56% uptake (current estimated uptake in Zimbabwe), 80% uptake (the WHO target), 95% uptake (reported in neighboring Botswana), and 100% uptake (to reflect maximum biologic efficacy of each regimen). The vertical axis illustrates three durations of breastfeeding (BF) for each modeled PMTCT regimen: 18 mo (median in Zimbabwe), 12 mo (concordant with 2010 WHO infant feeding guidelines), and no breastfeeding; ARV prophylaxis in the Option A and Option B regimens is assumed to continue throughout the duration of breastfeeding. The lower horizontal axis shows three categories of published MTCT risks for each drug regimen, including the lowest published risks, the average of published risks (the base-case parameters), and the highest published risks. The percentage in each cell reflects the MTCT risk associated with each set of parameters, and cells are color-coded to reflect broad categories of transmission. Red-colored cells indicate MTCT risks>10%, yellow-colored cells indicate MTCT risks between 5% and 10%, and green-colored cells indicate MTCT risks<5%.</p>", "links"=>[], "tags"=>["parameters", "mtct"], "article_id"=>364507, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.g003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Combinations_of_parameters_needed_to_achieve_MTCT_risks_lt_5_5_8211_10_and_gt_10_/364507", "title"=>"Combinations of parameters needed to achieve MTCT risks<5%, 5%–10%, and >10%.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-01-10 01:15:07"}
  • {"files"=>["https://ndownloader.figshare.com/files/694225"], "description"=>"<p>MOHCW, Zimbabwe Ministry of Health and Child Welfare.</p>", "links"=>[], "tags"=>["Infectious diseases", "public health and epidemiology", "pediatrics and child health"], "article_id"=>364647, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Model_input_parameters_infant_mortality_/364647", "title"=>"Model input parameters: infant mortality.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:17:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/694272"], "description"=>"<p>Results of a model of PMTCT services in Zimbabwe: cumulative 12-mo infant HIV infection risks.</p>", "links"=>[], "tags"=>["pmtct", "services", "cumulative", "12-mo", "hiv"], "article_id"=>364691, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Results_of_a_model_of_PMTCT_services_in_Zimbabwe_cumulative_12_mo_infant_HIV_infection_risks_/364691", "title"=>"Results of a model of PMTCT services in Zimbabwe: cumulative 12-mo infant HIV infection risks.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:18:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/694333"], "description"=>"<p>Results are shown with 56% uptake, sdNVP strategy. All data given as percents.</p>", "links"=>[], "tags"=>["uptake", "antenatal", "steps", "pmtct", "cascade", "mtct", "wk"], "article_id"=>364744, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t006"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_uptake_at_key_antenatal_steps_in_the_PMTCT_cascade_on_MTCT_at_4_8211_6_wk_of_age_/364744", "title"=>"Impact of uptake at key antenatal steps in the PMTCT cascade on MTCT at 4–6 wk of age.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:19:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/694400"], "description"=>"<p>To isolate the impact of linkage on postnatal care, results are shown for the base-case scenario of antenatal PMTCT uptake (56% uptake at the time of delivery).</p>", "links"=>[], "tags"=>["linkage", "postnatal", "wk", "uptake"], "article_id"=>364812, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t007"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_linkage_to_postnatal_care_by_6_wk_postpartum_following_56_uptake_at_delivery_/364812", "title"=>"Impact of linkage to postnatal care by 6 wk postpartum, following 56% uptake at delivery.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:20:12"}
  • {"files"=>["https://ndownloader.figshare.com/files/694455"], "description"=>"a<p>Proportion of pregnant women accessing ANC, HIV testing for those in ANC, and receipt of HIV test result for those tested.</p>b<p>Proportion of ANC sites with access to medications for PMTCT. This proportion is back-calculated in order to reach the reported POP for each scenario.</p>c<p>Of women offered ARVs for PMTCT, the proportion remaining in care during the antenatal period, used as a proxy for acceptance of and adherence to medications. Retention in care postpartum: Of all postpartum women, the proportion linking to HIV care by the 6-wk postpartum visit. Impacts on MTCT of loss to follow-up after 6 wk postpartum, in the absence of specific data, are incorporated into highest-risk transmission estimates.</p>d<p>Proportion of patients receiving care at all stages of the PMTCT cascade, defined as the product of (drug availability)×(care and testing)×(retention).</p>", "links"=>[], "tags"=>["uptake"], "article_id"=>364875, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_PMTCT_uptake_scenarios_/364875", "title"=>"PMTCT uptake scenarios.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:21:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/694498"], "description"=>"<p>Age given as mean (SD) in years; CD4 counts given as mean (SD) in number/microliter. Maternal disease progression: details of the CEPAC model and data inputs describing maternal HIV disease progression with and without ART are provided in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001156#pmed.1001156.s001\" target=\"_blank\">Text S1</a>.</p>a<p>ART eligibility defined as CD4≤350/µl or WHO stage 3/4 disease. In scenarios in which CD4 assays were not available, we simulated clinical assessment of ART eligibility. The sensitivity of clinical assessment of ART eligibility was reported for a CD4 threshold of 200/µl (36%); model sensitivity analyses using subsequent reports based on a CD4 threshold of 350/µl (sensitivity: 20%) did not substantially change the results <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001156#pmed.1001156-Carter1\" target=\"_blank\">[80]</a>.</p><p>MACS, Multicenter AIDS Cohort Study; MOHCW, Zimbabwe Ministry of Health and Child Welfare.</p>", "links"=>[], "tags"=>["maternal", "characteristics", "uptake", "pmtct"], "article_id"=>364918, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Model_input_parameters_maternal_characteristics_and_uptake_of_PMTCT_services_/364918", "title"=>"Model input parameters: maternal characteristics and uptake of PMTCT services.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:21:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/694546"], "description"=>"<p>Data given as base-case value [references] (range for sensitivity analysis) [references].</p>a<p>Antenatal ZDV reflects the antenatal component of the Option A regimen for women who are not eligible for ART. Per WHO 2010 PMTCT guidelines, the intrapartum sdNVP and 7-d postnatal ZDV/lamivudine “tail” components of the Option A regimen may be omitted if a woman receives>4 wk of antenatal ZDV. The cited transmission risks reflect a range of antenatal ZDV treatment durations, as well as studies both including and excluding the sdNVP and ZDV/lamivudine components. The Pediatric AIDS Clinical Trials Group Protocol 076 study <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001156#pmed.1001156-Connor1\" target=\"_blank\">[96]</a> was conducted in a replacement-fed population. However, this study demonstrated MTCT risks at the upper bound of the published range, reducing concern for underestimation of early postpartum MTCT risk, and thus was used in the “highest risk” scenario.</p><p>EBF, exclusive breastfeeding (in first 6 mo of life, followed by mixed breastfeeding); MBF, mixed breastfeeding; n/a, not applicable.</p>", "links"=>[], "tags"=>["mother-to-child"], "article_id"=>364967, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Model_input_parameters_mother_to_child_transmission_risks_/364967", "title"=>"Model input parameters: mother-to-child transmission risks.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:22:47"}
  • {"files"=>["https://ndownloader.figshare.com/files/694604"], "description"=>"a<p>Results highlight that providing CD4 assays for all women identified as HIV-infected, and ART for all women with CD4≤350/µl would lead to projected MTCT risks under the 2009 sdNVP-based program (56% uptake, sdNVP strategy: 11.4% at birth and 15.8% at 12 mo) comparable to if Option A were implemented at 56% uptake without increased CD4 and ART availability (56% uptake, Option A strategy: 12.0% at birth and 15.6% at 12 mo).</p>", "links"=>[], "tags"=>["cd4", "assays", "women"], "article_id"=>365015, "categories"=>["Medicine", "Infectious Diseases", "Biotechnology"], "users"=>["Andrea L. Ciaranello", "Freddy Perez", "Jo Keatinge", "Ji-Eun Park", "Barbara Engelsmann", "Matthews Maruva", "Rochelle P. Walensky", "François Dabis", "Jennifer Chu", "Asinath Rusibamayila", "Angela Mushavi", "Kenneth A. Freedberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001156.t008"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_availability_of_CD4_assays_and_ART_for_women_with_CD4_8804_350_181_l_/365015", "title"=>"Impact of availability of CD4 assays and ART for women with CD4≤350/µl.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-10 01:23:35"}

PMC Usage Stats | Further Information

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  • {"month"=>"2", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"3", "full-text"=>"115", "year"=>"2012", "pdf"=>"48", "unique-ip"=>"89", "figure"=>"14", "scanned-summary"=>"0", "supp-data"=>"0"}
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  • {"scanned-page-browse"=>"0", "month"=>"5", "cited-by"=>"0", "abstract"=>"1", "full-text"=>"79", "unique-ip"=>"78", "pdf"=>"51", "year"=>"2012", "figure"=>"5", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"6", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"45", "year"=>"2012", "pdf"=>"31", "unique-ip"=>"43", "figure"=>"1", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"unique-ip"=>"47", "full-text"=>"48", "pdf"=>"26", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"8", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"7"}
  • {"unique-ip"=>"39", "full-text"=>"42", "pdf"=>"34", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2012", "month"=>"8"}
  • {"unique-ip"=>"24", "full-text"=>"26", "pdf"=>"6", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"9"}
  • {"unique-ip"=>"60", "full-text"=>"58", "pdf"=>"40", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"10"}
  • {"unique-ip"=>"28", "full-text"=>"30", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2012", "month"=>"12"}
  • {"unique-ip"=>"28", "full-text"=>"31", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2013", "month"=>"1"}
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  • {"unique-ip"=>"39", "full-text"=>"38", "pdf"=>"18", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"3"}
  • {"unique-ip"=>"41", "full-text"=>"40", "pdf"=>"28", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"4"}
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