Incidence of Vertical-Transmission of HIV and Its Correlation with Maternal Gestational Age at Antenatal Booking in Port-Harcourt, Nigeria

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.

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Impact of breastfeeding, maternal antiretroviral treatment and health service factors on 18-month vertical transmission of HIV and HIV-free survival: results from a nationally representative HIV-exposed infant cohort, South Africa

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-213453 ◽

2020 ◽

pp. jech-2019-213453

Author(s):

Ameena Ebrahim Goga ◽

Carl Lombard ◽

Debra Jackson ◽

Vundli Ramokolo ◽

Nobubelo Kwanele Ngandu ◽

...

Keyword(s):

South Africa ◽

Health Service ◽

Vertical Transmission ◽

Antiretroviral Drugs ◽

Vertical Transmission Of Hiv ◽

Case Rate ◽

Nationally Representative ◽

Hiv Exposed ◽

Service Factors

BackgroundWe analysed the impact of breastfeeding, antiretroviral drugs and health service factors on cumulative (6 weeks to 18 months) vertical transmission of HIV (MTCT) and ‘MTCT-or-death’, in South Africa, and compared estimates with global impact criteria to validate MTCT elimination: (1) <5% final MTCT and (2) case rate ≤50 (new paediatric HIV infections/100 000 live births).Methods9120 infants aged 6 weeks were enrolled in a nationally representative survey. Of 2811 HIV-exposed uninfected infants (HEU), 2644 enrolled into follow-up (at 3, 6, 9, 12, 15 and 18 months). Using Kaplan-Meier analysis and weighted survey domain-based Cox proportional hazards models, we estimated cumulative risk of MTCT and ‘MTCT or death’ and risk factors for time-to-event outcomes, adjusting for study design and loss-to-follow-up.ResultsCumulative (final) MTCT was 4.3% (95% CI 3.7% to 5.0%); case rate was 1290. Postnatal MTCT (>6 weeks to 18 months) was 1.7% (95% CI 1.2% to 2.4%). Cumulative ‘MTCT-or-death’ was 6.3% (95% CI 5.5% to 7.3%); 81% and 62% of cumulative MTCT and ‘MTCT-or-death’, respectively, occurred by 6 months. Postnatal MTCT increased with unknown maternal CD4-cell-count (adjusted HR (aHR 2.66 (1.5–5.6)), undocumented maternal HIV status (aHR 2.21 (1.0–4.7)) and exclusive (aHR 2.3 (1.0–5.2)) or mixed (aHR 3.7 (1.2–11.4)) breastfeeding. Cumulative ‘MTCT-or death’ increased in households with ‘no refrigerator’ (aHR 1.7 (1.1–2.9)) and decreased if infants used nevirapine at 6 weeks (aHR 0.4 (0.2–0.9)).ConclusionsWhile the <5% final MTCT target was met, the case rate was 25-times above target. Systems are needed in the first 6 months post-delivery to optimise HEU health and fast-track ART initiation in newly diagnosed mothers.

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Mother-to-child HIV-transmission prevention programs in a sub-Saharan African setting: The Gabonese experience

International Journal of STD & AIDS ◽

10.1177/0956462417722132 ◽

2017 ◽

Vol 29 (3) ◽

pp. 221-226 ◽

Cited By ~ 2

Author(s):

Armel Mintsa-Ndong ◽

Corneille Ndong-Ella ◽

Roselyne K Boussougou ◽

Léatitia M Busugu ◽

Alexandre Mba ◽

...

Keyword(s):

Hiv Infection ◽

Antenatal Care ◽

Hiv Transmission ◽

Care Delivery ◽

Hiv Positive ◽

Hiv Exposed Infants ◽

Hiv Positive Mothers ◽

Sub Saharan ◽

Hiv Exposed ◽

Mother To Child

In many developing countries, mothers’ awareness remains a challenge despite the scaling up of antenatal care and programs preventing mother-to-child (MTC) HIV transmission. The present study was done in Libreville, Gabon where all antenatal care (delivery included) is free of charge. Here we assessed the timing of antenatal antiretroviral (ARV) prophylaxis initiation, HIV-exposed infants’ age at their first postnatal HIV check visit and investigated the association between mothers’ awareness or knowledge on their ARV therapy and infants’ HIV infection. We interviewed HIV-positive mothers on their first and subsequent laboratory visits to investigate infants’ HIV status and tested infants for HIV RNA and antibody between 2012 and 2014. We established that (1) of 718 HIV-positive mothers, only 6% were fully aware and knew what ARV treatment they were on during pregnancy; (2) half of the women (54%) start their antenatal ARV prophylaxis initiation during the second trimester of pregnancy; (3) 64% of HIV-exposed infants had their first HIV infection screening between birth and three months of age; (4) the overall prevalence of HIV infection in infants born from infected mothers was 8.9%; and (5) infants born from mothers uncertain about taking prophylactic ARV therapy were 13.3 times more likely to be infected by HIV than infants born from mothers certain about taking prophylactic ARV therapy. In conclusion, the study showed that despite free antenatal care, early access and adherence to components of MTC, HIV transmission preventive care remains unsatisfactory.

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HIV/AIDS and Children

International Journal of Nursing Education and Research ◽

10.52711/2454-2660.2021.00088 ◽

2021 ◽

pp. 376-380

Author(s):

Chandrashekhara Chandrashekhara ◽

Sandeepkumar O

Keyword(s):

Sexual Abuse ◽

Hiv Infection ◽

Vertical Transmission ◽

Hiv Positive ◽

Mother To Child Transmission ◽

Child Transmission ◽

Mother To Child ◽

Hiv Aids

Children are innocent victims of HIV infection through vertical transmission. Children who are HIV positive, either through mother-to-child transmission or following sexual abuse, are often not told what could happen to them, and they will certainly be frightened when they experience symptoms.

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