Effect of Dolutegravir-Based First-Line Antiretroviral Therapy on Mother-to-Child Transmission of HIV Among HIV-Exposed Infants in Ethiopia: a Before-and-After Study.
HIV AIDS (Auckl)
; 16: 203-215, 2024.
Article
em En
| MEDLINE
| ID: mdl-38765704
ABSTRACT
Background:
Currently, Dolutegravir (DTG)-based regimens are administered to women on Option B plus to prevent mother-to-child transmission (MTCT) of the virus. However, its effect on reducing MTCT of human immunodeficiency virus (HIV) among HIV-exposed infants over the previously used Efavirenz (EFV)-based regimen is unknown.Objective:
This study aimed to compare the effects of DTG-based and EFV-based regimens on the MTCT of HIV among HIV-exposed infants in Ethiopia.Methods:
An uncontrolled before-and-after study design was conducted among 958 mother-infant pairs (479 on EFV-based and 479 on DTG-based regimens) enrolled in the prevention of mother-to-child transmission (PMTCT) care from September 2015 to February 2023. The outcome variable was the HIV infection status among the exposed infants. A log-binomial model was employed, and the proportion was computed to compare the incidence of MTCT of HIV in both groups. The risk ratio (RR) with a 95% confidence interval (CI) was calculated to assess the predictor variables.Results:
Mothers on DTG-based regimens were approximately 44% (adjusted risk ratio (aRR) 0.56; 95% CI 0.44, 0.70) less likely to transmit HIV to their infants than those on EFV-based regimens. In addition, poor or fair adherence to antiretroviral therapy (ART) (aRR 5.82; 95% CI 3.41, 9.93), home delivery (aRR 3.61; 95% CI 2.32, 5.62), mixed feeding practice (aRR 1.83; 95% CI 1.45, 2.3) and not receiving antiretroviral prophylaxis (aRR 3.26; 95% CI 1.6, 6.64) were found to increase the risk of MTCT of HIV infection, whereas older maternal age (aRR 0.93; 95% CI 0.9, 0.96) was a protective factor.Conclusion:
Mother-to-child transmission of HIV was less frequently observed in mother-infant pairs exposed to the DTG-based regimens as compared to those exposed to the EFV-based regimens. Thus, DTG-based first-line ART regimens supplementation should be sustained to achieve global and national targets for zero new infections in HIV-exposed infants.
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Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article