Impact of Option B+ Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe.
AIDS Patient Care STDS
; 36(4): 145-152, 2022 04.
Article
em En
| MEDLINE
| ID: mdl-35438521
ABSTRACT
We conducted a 24-month prospective follow-up study, at a primary health care clinic in Harare, Zimbabwe, to determine cumulative mother-to-child transmission of HIV-1 (MTCT) rate and the contributions of intrauterine (IU), intrapartum (IP), and postpartum (PP) to MTCT, as well as maternal and infant mortality rates in the era of Option B+ combination antiretroviral therapy (cART). Plasma for viral load (VL) quantitation was obtained from 475 mothers enrolled into the study. VL was quantified at enrolment and every 6 months thereafter up to 24 months using the Cepheid GeneXpert HIV-1 Quantitative test. Dried blood spots were collected from 453 infants at birth, 4-6 weeks, 3 months, and every 3 months thereafter up to 24 months. HIV-1 infant diagnosis was conducted using the Cepheid GeneXpert HIV-1 Qualitative test. Absolute, cumulative MTCT rates and mortality rate were calculated. Seven mothers (1.55%) transmitted HIV-1 infection to their infants by 24 months. Four infants (0.88%; 95% CI 0.26-2.33%), one infant (0.22%; 95% CI 0-1.4%), and two infants (0.44%; 95% CI 0.01-1.7%) were infected IU, IP, and PP, respectively. By 24 months, 88.94% of the mothers and 80% of the infants had undetectable VL. The maternal and infant mortality rates were 0.21% and 1.78%, respectively. In the first 24 months of life, IU transmission is the major route of MTCT. The cumulative MTCT rate of 1.55% and low maternal and infant mortality rates of 0.21% and 1.78%, respectively, contribute to growing evidence that Option B+ cART not only drastically reduces MTCT but also maternal and infant mortality.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Infecciosas na Gravidez
/
Infecções por HIV
/
HIV-1
/
Soropositividade para HIV
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Infant
/
Newborn
/
Pregnancy
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article