{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:33:52Z","timestamp":1784543632774,"version":"3.55.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Children's Hospital of Philadelphia Global Health Pilot Grant"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The post-delivery period is a critical window for sustaining maternal viral suppression (VS) to prevent vertical transmission (VT) of HIV during breastfeeding. Despite Ghana\u2019s national scale-up of dolutegravir-based antiretroviral therapy, limited data exist on viral load suppression and infant HIV outcomes in the year post-delivery. We aimed to determine the proportion of women who achieved and maintained a suppressed viral load (VL) (\u2264\u20091000 copies\/mL) and an undetectable VL (&lt;\u200920 copies\/mL) at 12 months post-delivery and examine associations between maternal characteristics and VL categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective longitudinal cohort study among 120 women living with HIV receiving ART across two tertiary hospitals in Ghana. Women were enrolled during late pregnancy or early post-delivery and followed up at 6 weeks and 3-, 6-, and 12-months post-delivery, during which maternal VL was monitored. Infant HIV status was documented at 6 weeks and 9 months in accordance with national guidelines. Our co-primary outcomes were VL suppression and undetectable VL at 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median maternal age was 31.0 years (28.0, 36.3), and nearly half of the participants had attained only primary-level education (58\/120; 46.7%). At 12 months post-delivery, 65 participants (54.2%) had documented VS, and out of this, 41 (34.2%) had an undetectable VL. Two cases of VT of HIV were documented: one at 6 weeks (maternal VL 669 copies\/mL) and another at 6 months (maternal VL 64 copies\/mL), underscoring the transmission risk even with low-level viremia. VL data were missing among 49 participants (40.8%) despite follow-up efforts. Women on the tenofovir\/lamivudine\/dolutegravir regimen were more likely to achieve suppression than were those on the regimen without an integrase inhibitor,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Just over half of women achieved VS at 12 months post-delivery. VT occurred even at low levels of maternal viremia, underscoring the importance of sustained VL monitoring and optimisation of antiretroviral therapy during the post-delivery period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13282-x","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T01:44:53Z","timestamp":1776131093000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Viral load suppression among pregnant and breastfeeding women living with HIV in Ghana: a prospective longitudinal study"],"prefix":"10.1186","volume":"26","author":[{"given":"Joycelyn Assimeng","family":"Dame","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira J.","family":"Nightingale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Promise","family":"Sefogah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islynn","family":"Aggrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derartu","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adwoa K. 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The study was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants prior to enrollment. For participants who were illiterate, the study information and consent form were read and explained in the local language by trained multilingual staff, and consent was documented by thumbprint in the presence of an impartial witness prior to participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1012"}}