Article

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

Public health, IRSS, Ouagadougou, Burkina Faso.
AIDS Care (Impact Factor: 1.6). 07/2010; 22(7):843-50. DOI: 10.1080/09540120903499204
Source: PubMed

ABSTRACT Mother-to-child transmission remains the main cause of global pediatric HIV infections, especially in sub-Saharan Africa. Many interventions based on single-dose antiretroviral therapy have been implemented to reduce the mother-to-child transmission of HIV. In resource-limited settings, highly active antiretroviral therapy (HAART) has only been recommended for HIV-infected pregnant women requiring treatment for their own health. Here, we assessed the efficacy over 18 months of maternal HAART versus peripartum short-course antiretroviral therapy (SCART) regimens for the prevention of mother-to-child transmission (PMTCT) of HIV. We conducted a retrospective cohort study of patients from two medical centers in Ouagadougou, Burkina Faso. The PMTCT files and registers from 1 January 2003 to 31 December 2006 were obtained from routine data collected at these sites. The main assessment criterion was the rate of HIV-1 positivity in children born to HIV-positive mothers as measured with HIV-1 rapid tests at 18 months. A total of 586 pregnant HIV-1-infected women in PMTCT programs were selected. Among these women, 260 were undergoing HAART and 326 received single-dose nevirapine (91.3%) or single-dose zidovudine (8.7%) at delivery. HIV-1 serological tests were performed on 454 children at 18 months old. The rate of HIV-1 vertical transmission was 0% (0/195) in the HAART group and 4.6% (12/259) in the single-dose monotherapy group (P<0.01). Eight infants in the HAART cohort and 30 in the SCART cohort were breastfed; three in the SCART group were HIV-positive. A total of 62 children died, 19 in the HAART group and 43 in the single-dose monotherapy group. Our study confirms that HAART for mothers effectively reduces the risk of infant HIV infection while preserving the breastfeeding option for mothers.

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    • "For more than a decade, effective antiretroviral (ARV) treatment has been available for the prevention of motherto-child transmission of HIV (PMTCT), and highly active ARV therapy (HAART) for lifelong treatment is becoming increasingly accessible worldwide (UNAIDS 2010). Many studies have demonstrated the effectiveness of HAART during pregnancy and breastfeeding to reduce vertical transmission when compared with no intervention and with short-course PMTCT regimens (Thomas et al. 2008; Kilewo et al. 2009; Shapiro et al. 2009; de Vincenzi and Study Kesho Bora Group 2009; Kouanda et al. 2010, The Kesho Bora Study Group 2011). Even where it is impossible to initiate HAART during pregnancy, mother-to-child HIV transmission can be reduced by promoting rapid uptake of HAART following delivery (Taha et al. 2009). "
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