DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20183865

Prevention of parent to child transmission of HIV: where are we? a decade’s analysis

Manoj Donthamsetty, Siddharth E. S., S. Mruthyunjaya, C. R. Banapurmath

Abstract


Background: Vertical transmission of HIV remains the main source of pediatric HIV infection with transmission rates as high as 25%-45% without intervention. This rate can be reduced to levels below 2% with effective interventions.

Methods: This study summarizes the interventions taken up by the PPTCT centre from 2003 to 2014. The interventions were based on WHO guidelines adopted by NACO. All HIV positive mothers who were followed up or referred to sisu raksha-PPTCT centre were included in the study and their infants were followed up till 18 months of age. All the HIV positive mothers were given appropriate counselling and CD4 count estimation was done. They were given antiretroviral drugs as per respective WHO guidelines adopted by NACO and were counselled regarding feeding option. The babies were given antiretroviral drugs as per guidelines and were followed up for a period of 18 months after birth.

Results: From 2003 to 2010, the rate of mother to child transmission was 5.2% (30/573). From 2011 to 2014, after implementation of WHO 2010 guidelines, the transmission rate reduced to 3.5% (12/342). Further analysis of the data was done. From 2003 to 2010, 72.6% (441/607) mothers practiced exclusive breastfeeding. From 2011 and 2014, 95.5% (345/361) mothers practiced exclusive breastfeeding.

Conclusions: Effective implementation of WHO PPTCT guidelines, early diagnosis in pregnancy, antiretroviral drug intake in mother and Nevirapine prophylaxis to the baby together reduce mother to child transmission of HIV considerably.


Keywords


HIV (Human Immunodeficiency Virus), NACO (National AIDS Control Organization), PPTCT (Prevention of Parent to Child Transmission), WHO (World Health Organization)

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References


World Health Organization. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health. WHO. 2010. Available at http://www.who.int/hiv/pub/mtct/antiretroviral2010/en/

World Health Organization. Use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Programmatic update. WHO. 2012. Available at http://www.who.int/hiv/pub/mtct/programmatic_update2012/en/

World Health Organization. PMTCT strategic vision 2010-2015: preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals. WHO. Available at http://www.who.int/hiv/pub/mtct/strategic_vision/en/

World Health Organization. World Health Organization guidelines on HIV and infant feeding. 2010. Principles and recommendations for infant feeding in the context of HIV and a summary of evidence. WHO. 2010. Available at http://www.who.int/maternal_child_adolescent/documents/9789241599535/en/

Sherman GG, Jones SA, Coovadia AH, Urban MF, Bolton KD. PMTCT from research to reality - results from a routine service. South Afr Med J. 2004;94(4):289-92.

Shapiro RL, Hughes MD, Ogwu A, Kitch D, Lockman S, Moffat C, et al. Antiretroviral regimens in pregnancyand breast-feeding in Botswana. N Engl J Med. 2010;362:2282-94.

Edathodu J, Halim MM, Dahham MB, Alrajhi AA. Mother-to-child transmission of HIV: experience at a referral hospital in Saudi Arabia. Ann Saudi Med. 2010;30(1):15-7.

Srivastava A, Wadhwa R, Kapur A, Agarwal R. Road to elimination of vertical transfer of HIV to child from mother. In: BJOG special Issue: Abstracts of the RCOG World Congress. 2014:151.

Ekouevi DK, Coffie PA, Becquet R, Tonwe-Gold B, Horo A. Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Côte d'Ivoire. AIDS. 2008;22:1815-20.

Youngleson MS, Nkurunziza P, Jennings K, Arendse J, Mate KS. Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition. PLoS One. 2010;5:e13891.

Tchendjou P, Same-Ekobo C, Nga A, Tejiokem M, Kfutwah A. Effectiveness of multidrug antiretroviral regimens to prevent mother-to-child transmission of HIV-1 in routine public health services in Cameroon. PLoS One. 2010;5:e10411.

Azcoaga-Lorenzo A, Ferreyra C, Alvarez A, Palma PP, Velilla E. Effectiveness of a PMTCT programme in rural Western Kenya. AIDS Care. 2001;23:274-80.

Kouanda S, Tougri H, Cisse M, Simpore J, Pietra V, et al. Impact of maternal HAART on the prevention of mother-to-child transmission of HIV: results of an 18-month follow-up study in Ouagadougou, Burkina Faso. AIDS Care. 2010;22:843-50.

Ahoua L, Ayikoru H, Gnauck K, Odaru G, Odar E, et al. Evaluation of a 5-year programme to prevent mother-to-child transmission of HIV infection in Northern Uganda. J Trop Pediatr. 2010;56:43-52.