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AIDS Research and Treatment
Volume 2015 (2015), Article ID 740212, 11 pages
http://dx.doi.org/10.1155/2015/740212
Clinical Study

Combination Antiretroviral Therapy for HIV in Rwandan Adults: Clinical Outcomes and Impact on Reproductive Health up to 24 Months

1INTERACT Program, Kigali, Rwanda
2College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
3Academic Medical Center (AMC), Department of Global Health and Amsterdam Institute for Global Health and Development (AIGHD), 1105 BM Amsterdam, Netherlands
4Department of Epidemiology and Biostatistics, VU University Medical Center, 1007 MB Amsterdam, Netherlands
5Treatment and Research for AIDS Center (TRAC-Plus), Kigali, Rwanda
6National Reference Laboratory, Kigali, Rwanda
7Institute of Infection and Global Health, University of Liverpool, Liverpool L69 7BE, UK
8Kigali University Teaching Hospital, Kigali, Rwanda
9Rinda Ubuzima, Kigali, Rwanda
10Biomedical Research, Royal Tropical Institute, 1105 AZ Amsterdam, Netherlands
11Ministry of Health of Rwanda, Rwanda

Received 16 April 2015; Revised 28 June 2015; Accepted 29 June 2015

Academic Editor: David Katzenstein

Copyright © 2015 Brenda Asiimwe-Kateera et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Adult women () and men () initiating combination antiretroviral therapy (cART) and women not yet eligible for cART () in Kigali, Rwanda, were followed for 6–24 months between 2007 and 2010. In the cART groups, 21% of patients required a drug change due to side effects and 11% of patients had virological failure (defined as >1,000 HIV RNA copies/mL) after 12 months of cART. About a third of the pregnancies since HIV diagnosis were unintended. The proportion of women in the pre-cART group using modern contraception other than condoms (50%) was similar to women in the general population, but this proportion was only 25% in women initiating cART. Of the women who carried at least one pregnancy to term since having been diagnosed HIV-positive, a third reported to have participated in a prevention-of-mother-to-child-transmission (PMTCT, option A) intervention. Many patients were coinfected with herpes simplex virus type 2 (79–92%), human papillomavirus (38–53%), and bacterial sexually transmitted infections (STIs) with no differences between groups. We applaud the Rwandan government for having strengthened family planning and PMTCT services and for having introduced HPV vaccination in recent years, but additional work is needed to strengthen STI and HPV-related cancer screening and management in the HIV-positive population.