The Impact of Maternal Highly Active Antiretroviral Therapy and Short-Course Combination Antiretrovirals for Prevention of Mother-to-Child Transmission on Early Infant Infection Rates at the Mulago National Referral Hospital in Kampala, Uganda, January 2007 to May 2009
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
JAIDS Journal of Acquired Immune Deficiency Syndromes
Abstract
Early HIV infant diagnosis and treatment have been
shown to dramatically improve survival in infants. Despite these
findings, infants accessing HIV diagnosis and treatment remain low
in Uganda. We describe the antiretroviral (ARV) drugs given in the
Mulago Hospital prevention of mother-to-child transmission
(PMTCT) program from January 2007 to May 2009 and its impact
on early infant HIV infection rates.
Methods: Pregnant women identified as HIV infected in the Mulago
antenatal clinics received one of the following regimens: short-course
ARV prophylaxis plus single-dose nevirapine (sdNVP) in labor,
highly active antiretroviral therapy (HAART), or sdNVP if they
presented in labor. Infants received sdNVP and zidovudine (ZDV) for
1 week. Infants HIV diagnosis was done from 6 weeks after delivery.
Results: 62.3% of HIV-infected women received combination ARVs,
including HAART. Early infection rates were highest among infants
with no maternal ARV [36.4; 95% confidence interval (CI): 17.2 to
59.3] or only sdNVP (11.2; 95% CI: 8.1 to 14.8). Similar rates were
observed for the group that took short-course ARVs, ZDV/sdNVP (4.6;
95% CI: 3.2 to 6.4), and ZDV/lamivudine/sdNVP (4.9; 95% CI: 3.1 to
7.2) and lowest rates for those that took HAART (1.7: 95% CI: 0.8 to
2.8). Overall infection rate was 5.0% (95% CI: 4.1 to 5.9).
Conclusions: Findings indicate low rates of infant infection for
mothers receiving combination ARVs. These findings demonstrate
that provision of combination ARV for PMTCT is feasible and
effective in busy referral hospital’s PMTCT programs in resource-
limited settings
Description
Keywords
HIV, PMTCT, Antiretroviral therapy, Infant infection rateh
Citation
Citer Namukwaya, Z., Mudiope, P., Kekitiinwa, A., Musoke, P., Matovu, J., Kayma, S., ... & Fowler, M. G. (2011). The impact of maternal highly active antiretroviral therapy and short-course combination antiretrovirals for prevention of mother-to-child transmission on early infant infection rates at the Mulago national referral hospital in Kampala, Uganda, January 2007 to May 2009. JAIDS Journal of Acquired Immune Deficiency Syndromes, 56(1), 69-75.