Background: Pregnancy associated with human immunodeficiency virus (HIV)- infection poses risk to the fetus due to vertical-transmission. This can be prevented through administration of antiretroviral drugs. Our objective was to investigate the incidence of vertical-transmission of HIV and its correlation with maternal gestational age at antenatal booking with immediate commencement of antiretroviral therapy in Port-Harcourt, Nigeria.
Methods: All antenatal attendees and their HIV-exposed newborns were screened for HIV-infection between April, 2016 and May, 2017 using qualitative rapid ELISA kits and HIV-DNA PCR technique. The HIV-positive antenatal attendees were placed on daily single-dose triple antiretroviral regimen (efavirenz, lamivudine, tenofovir, 600/300/300mg tablet) with multivitamins from the first day of booking and continued afterward. The HIV-exposed babies were placed on 5ml daily single-dose triple antiretroviral chemoprophylaxis on the first day of delivery and continued until blood collection at 6 weeks for HIV diagnosis. Statistical Package for Social Science (SPSS) software (version 17.0) was used for data analysis.
Results: We found 4.34% overall prevalence of HIV-1 infection among the antenatal attendees and 7.57% incidence of mother-to-child transmission. There was significant difference between gestational age at booking with commencement of ART and the number of HIV-positive babies (χ2=7.113, df=2, P<0.05). There was no vertical transmission among the attendees who booked at first trimester, 35.7% at second trimester and 64.3% at third trimester. There was no statistically significant gender difference (P>0.05) between the number of infected males, 42.9% and females, 57.1%.
Conclusion: High incidence of vertical-transmission of HIV was obtained from those HIV-positive mothers who registered late for antenatal care. Therefore, strong advocacy for early entry into antenatal care is solicited.
Outcome of PMTCT services and factors affecting vertical transmission of HIV infection in Lagos, Nigeria
