Maternal Adherence to the Zidovudine Regimen for HIV-Exposed Infants to Prevent HIV Infection: A Preliminary Study

Abstract Background In the era of highly active antiretroviral therapy, vertical HIV transmission has been decreased. This may increase fertility desire of HIV infected women and an increasing number of HIV exposed infants as a result. A high probability of mortality among HIV exposed infants was reported across different countries. However, few studies are found on mortality of HIV exposed infants, in particular, no study was conducted before in the current study area. Methods Institution based retrospective cohort study from July 2013 to December 2017 was conducted. A total of 408 HIV exposed children were selected through simple random sampling technique. Data were extracted from registration book by using data extraction tool, which is adapted from the Ethiopian Federal Ministry of Health HIV exposed infant follow-up form. Kaplan–Meier survival curve was used to show the probability of mortality rate. Bivariable and multivariable cox regression models were used to identify predictors of mortality. Results Overall mortality rate was found to be 8.88 (95% CI: 6.36–12.36) per 100 child-year. Infant with death of at least one parent (AHR = 3.32; 95% CI: 1.503–7.32), non-exclusive breastfeeding (AHR = 0.10; 95% CI: 0.037–0.302), growth failure (AHR = 2.9; 95% CI: 1.09–8.09), presence of sign and symptom of HIV infection (AHR = 2.99; 95% CI: 1.33–6.74), and low birth weight (AHR = 2.6; 95% CI: 1.007–6.78) were found to be predictors of infant mortality. Conclusions Mortality of HIV exposed infants was high in Ethiopia. Prevention of the occurrence of HIV infection symptom, growth failure, and low birth weight is essential and further treat early whenever they occurred. Still, behavioral change interventions on mother who practice non-exclusive breastfeeding are indicated. Especial care for orphan infants is required due to their nature of vulnerability to varieties of health problem.

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Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya

International Journal of STD & AIDS ◽

10.1177/0956462417693735 ◽

2017 ◽

Vol 28 (12) ◽

pp. 1215-1223 ◽

Cited By ~ 8

Author(s):

Nicollate A Okoko ◽

Kevin O Owuor ◽

Jayne L Kulzer ◽

George O Owino ◽

Irene A Ogolla ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Transmission ◽

Poor Adherence ◽

Pmtct Service ◽

Hiv Education ◽

Mother To Child Transmission ◽

Child Transmission ◽

Hiv Exposed Infants ◽

Hiv Exposed ◽

Mother To Child

Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case–control study of HIV-exposed infants between January and June 2012 was conducted at 20 clinics in Kenya. Cases were HIV-infected infants and controls were exposed, uninfected infants. Conditional logistic regression analysis was conducted to determine characteristics associated with HIV infection. Forty-five cases and 45 controls were compared. Characteristics associated with HIV-infection included poor PMTCT service uptake such as late infant enrollment (odds ratio [OR]: 7.1, 95% confidence interval [CI]: 2.6–16.7) and poor adherence to infant prophylaxis (OR: 8.3, 95%CI: 3.2–21.4). Maternal characteristics associated with MTCT included lack of awareness of HIV status (OR: 5.6, 95%CI: 2.2–14.5), failure to access antiretroviral prophylaxis (OR: 22.2, 95%CI: 5.8–84.6), and poor adherence (OR: 8.1, 95%CI: 3.7–17.8). Lack of clinic-based HIV education (OR: 7.7, 95%CI: 2.0–25.0) and counseling (OR: 8.3, 95%CI: 2.2–33.3) were reported by mothers of cases. Poor uptake of PMTCT services and a reported absence of HIV education and counseling at the clinic were associated with MTCT. More emphasis on high-quality, comprehensive PMTCT service provision are urgently needed to minimize HIV transmission to children.

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Growth of HIV-exposed infants from birth to 6 months in the prevention of mother-to-child transmission program

Paediatrica Indonesiana ◽

10.14238/pi59.4.2019.183-7 ◽

2019 ◽

Vol 59 (4) ◽

pp. 183-7

Author(s):

Maria Priskila ◽

Ketut Dewi Kumarawati ◽

Ni Putu Siadi Purniti

Keyword(s):

Birth Weight ◽

Hiv Infection ◽

Distributed Data ◽

Pmtct Program ◽

Child Transmission ◽

Post Hoc Analysis ◽

Hiv Exposed Infants ◽

Hiv Exposed ◽

Post Hoc ◽

Mother To Child

Background Human immunodeficiency virus (HIV) infection is a global health issue. Most cases of HIV infection in children are acquired through transmission from HIV-infected mothers. Maternal HIV infection affects infant growth. Objective To evaluate the first six months of growth in HIV-exposed infants born to mothers in the prevention of mother-to-child transmission (PMTCT) program. Methods This prospective cohort study was done in 40 HIV-exposed infants born in Sanglah General Hospital, Bali. Subjects’ underwent weight and length measurements at birth and monthly for 6 months. Data analyses used were repeated ANOVA test with Bonferonni post-hoc analysis for normally distributed data and Friedman test with Wilcoxon post-hoc analysis for abnormally distributed data. Correlations between birth weight and length to weight and length at 6 months of age were analyzed with Spearman’s test. Results Subjects’ mean birth weight was 2,900 (SD 546) grams and median birth length was 48 (range 36-52) cm. Subjects’ body weight and length increased monthly throughout the measurement period (P<0.001). There was a strong negative correlation between birth weight and infant weight gain at 6 months of age (r=-0.678), and a moderate negative correlation between birth length and infant length gain at 6 months of age (r=-0.564). Conclusion HIV-exposed infants born to mothers in the PMTCT program have a significant body weight and body length growth in the first 6 months of life, and followed general WHO weight and length curves for age.

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Prevention of Mother-to-Child HIV Transmission in Nigeria: Six Years Experience from a Tertiary Institution

Current HIV Research ◽

10.2174/1570162x19666210607113153 ◽

2021 ◽

Vol 19 ◽

Author(s):

Rabiu Ibrahim Jalo ◽

Taiwo Amole ◽

Deepa Dongarwar ◽

Hadiza Abdullahi ◽

Fatima I. Tsiga-Ahmed ◽

...

Keyword(s):

Hiv Infection ◽

Infection Rate ◽

Hiv Transmission ◽

Early Infant Diagnosis ◽

Mixed Feeding ◽

Hiv Exposed Infants ◽

Early Infant ◽

Antiretroviral Prophylaxis ◽

Hiv Exposed ◽

Mother To Child

Background: In line with global standards and progress made in Prevention of Mother-to-Child Transmission (PMTCT), an assessment of the outcome of Early Infant Diagnosis in northern Nigeria is necessary to evaluate progress towards a zero Human immunodeficiency Virus (HIV) infection rate among children. Objectives: This study assessed the infection rate and risk factors for mother-to-child HIV transmission among HIV-exposed children in Kano, northwest Nigeria. Method: Using a retrospective cohort design, pregnant HIV-positive women and their exposed infants were recruited over a period of six years (2010 to 2016). Participants were enrolled during pregnancy or at delivery from the PMTCT clinic of a tertiary health facility in Kano, Nigeria. The main observations of the study were Early infant diagnosis positivity for HIV at 6 weeks and the risk factors for positivity. Results: Of the 1,514 infants studied, Early Infant Diagnosis was positive for HIV among 13 infants (0.86%). Infants whose mothers did not have antiretroviral therapy (adjusted Prevalence Ratio aPR = 2.58, 95%CI [1.85- 3.57]); who had mixed feeding (aPR = 12.06, 95%CI [9.86- 14.70]) and those not on antiretroviral prophylaxis (aPR = 20.39, 95%CI [16.04- 25.71]) were more likely to be infected with HIV. HIV-exposed infants on nevirapine and zidovudine prophylaxis accounted for 95% and 74%, respectively, and were less likely to be infected with HIV. Conclusion: HIV infection rate remains high among HIV-exposed infants whose mothers did not receive PMTCT services. Scaling up proven interventions of early commencement of antiretroviral treatment for mothers, adherence to antiretroviral prophylaxis and avoidance of mixed feeding among HIV-exposed infants would protect future generations from HIV infection.

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Mother-to-Child Transmission of HIV Infection and Its Determinants among Exposed Infants on Care and Follow-Up in Dire Dawa City, Eastern Ethiopia

AIDS Research and Treatment ◽

10.1155/2016/3262746 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Fisseha Wudineh ◽

Bereket Damtew

Keyword(s):

Hiv Infection ◽

Scale Up ◽

Hiv Positive ◽

Mother To Child Transmission ◽

Child Transmission ◽

Hiv Exposed Infants ◽

Dire Dawa ◽

Hiv Exposed ◽

Mother To Child

Since the scale-up for prevention of mother-to-child transmission (PMTCT) services, rates of HIV infection among exposed infants have significantly declined. However, current achievements fell short of achieving the target sets. We investigated mother-to-child transmission (MTCT) of HIV infection and its determinants among HIV-exposed infants on care at Dilchora Referral Hospital in Dire Dawa City Administration. A retrospective institutional cohort study was conducted by reviewing follow-up records of HIV-exposed infants who were enrolled into care. Infants’ HIV serostatus was the outcome measure of the study. Bivariate and multivariate logistic regressions were employed to identify significant determinants. Of the 382 HIV-exposed infants enrolled into care, 60 (15.7%) became HIV positive. Rural residence (AOR: 3.29; 95% CI: 1.40, 7.22), home delivery (AOR: 3.35; 95% CI: 1.58, 8.38), infant not receiving ARV prophylaxis at birth (AOR: 5.83; 95% CI: 2.84, 11.94), mixed feeding practices (AOR: 42.21; 95% CI: 8.31, 214.38), and mother-child pairs neither receiving ARV (AOR: 4.42; 95% CI: 2.01, 9.82) were significant independent determinants of MTCT of HIV infection. Our findings suggest additional efforts to intensify scale-up of PMTCT services in rural setting and improve institutional delivery and postnatal care for HIV positive mothers and proper follow-up for HIV-exposed infants.

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Malarial Morbidity and Postnatal HIV Infection in Breastfeeding HIV-exposed Infants

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2014/6085 ◽

2014 ◽

Vol 4 (1) ◽

pp. 18-30 ◽

Cited By ~ 1

Author(s):

Amara Ezeamama

Keyword(s):

Hiv Infection ◽

Hiv Exposed Infants ◽

Hiv Exposed

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Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

Tropical Medicine and Health ◽

10.1186/s41182-020-00273-0 ◽

2020 ◽

Vol 48 (1) ◽

Author(s):

Amare Belachew ◽

Tilahun Tewabe ◽

Gizat Abinet Malede

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Hiv Infection ◽

East Africa ◽

Meta Analysis ◽

World Health ◽

Hiv Exposed Infants ◽

Pooled Prevalence ◽

The World ◽

Hiv Exposed

Abstract Background Human immunodeficiency virus (HIV) is one of the most important global health problems. More than one and half million of children are living with HIV in the world, and majority of them are found in sub-Saharan Africa. There are primary fragmented study findings, and no review was conducted with regard to vertical HIV infection in East Africa. Therefore, this review aimed to assess the prevalence of vertical HIV infection and its risk factors among HIV-exposed infants in East Africa. Main body Eligible studies were retrieved by relevant search terms in CINHAL, Pub-MED, Google Scholar, EMBASE, Web of Science, SCOPUS, Cochrane, African Journals Online databases, and Ethiopian University research repositories. Data were extracted with Microsoft Excel and analyzed with Stata version 11 software. The random effect model was used to estimate the pooled prevalence of vertical HIV infection in East Africa. The variation between studies was quantified with an I2 statistic test. Furthermore, sub-group and meta-regression analyses were done to identify the sources of heterogeneity between the studies. The publication bias was assessed by Egger test. This systematic review and meta-analysis have included a total of 33 research articles. The overall pooled prevalence of vertical HIV infection in East Africa was 7.68% with a 95% confidence interval [CI]: (6.23, 9.12) with a heterogeneity of I2 = 86.8 with a p value < 0.001. In subgroup analysis, the pooled prevalence of vertical HIV infection in cross-sectional studies was 6.58%, while in cohort studies were 9.37%. Mixed feeding, AOR = 6.22 (1.02, 11.41); home delivery, AOR = 2 (1.01, 3); mothers took ART less than 4 weeks, AOR = 1.92 (1.79, 2.06); and infants who have not received ARV prophylaxis, AOR = 2.02 (1.05, 2.98) were the associated factors for vertical HIV infection for exposed infants. Conclusions The pooled prevalence of the mother to child transmission of HIV is way more than the desired target of the World Health Organization, which is less than 5% in breastfeeding populations. Thus, strengthening the prevention of vertical HIV transmission, promotion of exclusive breastfeeding, timely initiation of ART prophylaxis for HIV exposed infants, encouragement of hospital delivery, and the start of ART at the time of diagnosis of every HIV-positive person may all reduce the transmission of vertical HIV infection.

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