Abstract:

Introduction: Over 90% of HIV infections in children are acquired through the mother-to-child transmission route. Mother to child transmission can be prevented through use of efficacious antiretroviral drug regimens and complete avoidance of breastfeeding. This study evaluated the effectiveness of PMTCT program in Benue State, Nigeria.

Methods: This was a retrospective study of infants and children perinatally exposed to HIV aged 6 weeks -18 months from Benue State, Nigeria. 5734 consecutive sample of infants and children identified from the EID laboratory register from January 2017-December 2017 were enrolled for this study. The details of ARV therapy commencement for mother and baby, infant feeding choices, and HIV PCR DNA test results were analyzed using SPSS version 20.

Result: 225 out of 5734 exposed babies tested positive to HIV giving an overall prevalence of 3.9% (95% CI: 3.4 -4.4). When neither mother nor baby received ARVs the prevalence was 33%; when only baby received ARVs the prevalence was 10.8%; when only mother received ARVs the prevalence was 9.1% and when both mother and baby received ARV for PMTCT the prevalence reduced to 1.5%.

Conclusions: This study has shown the usefulness of ARVs as the single most important intervention in PMTCT. There was a high prevalence of HIV among exposed children in our setting, especially if the mother and child pairs did not receive any form of antiretroviral prophylaxis. Therefore, there is need to expand antiretroviral coverage, ensure access of the PMTCT program, and provide effective services to support infected children.

Keywords: prevention of mother-to-child HIV transmission, PMTCT, HIV, antiretroviral prophylaxis.

References:

[1].   Agboghoroma C, Audu LI, Iregbu KC (2015) Effectiveness of prevention of mother-to-child transmission of HIV program in Abuja, Nigeria. Journal of HIV and human reproduction Year: 2015 | Volume: 3 | Issue: 1 | Page: 7-13 DOI: 10.4103/2321-9157.169176(Online).

http://www.j-hhr.org/article.asp?issn=2321-9157;year=2015;volume=3;issue=1;spage=7;epage=13;aulast=Agboghoroma (Accessed 2 January,2019).

[2].   Agboghoroma OC. Prevention of mother-to-child transmission of HIV/AIDS. In: Okonofua FE, editor. Confronting the Challenge of Reproductive Health in Africa: A Textbook for Students and Development Practitioners. Benin: WHARC; 2014. p. 347-68.

[3].   Chukwuemeka IK, Isa FC, Kabiru ZK, Olukayode O, (2014). The impact of a HIV prevention of mother to child transmission program in a Nigerian early infant diagnosis Centre. Year: 2014 | Volume: 55 | Issue: 3 | Page: 204-208(Online) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089047/ (Accessed 8 February,2019).

[4].   De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, … Shaffer N. (2000). Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Jama, 2000. 283(9): p. 1175–1182. https://doi.org/10.1001/jama.283.9.1175 (Accessed 1 January, 2019).

[5].   Eka PO, Ojabo AO, Hembah-Hilekaan SK, Utoo BT, Audu O and Ben-Ameh JO (2016). HIV infection: Prevalence and seroconversion in a cohort of antenatal attendees at the Benue State University Teaching Hospital, Makurdi, Nigeria. Department of Obstetrics and Gynaecology, BSUTH, Makurdi, Nigeria (online) http://www.archintsurg.org/article.asp?issn=2278-9596;year=2016;volume=6;issue=4;spage=206;epage=209;aulast=Eka (Accessed 5 December,2018).

[6].   European Collaborative Study. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy. Clin Infect Dis 2005; 40:458-65.

[7].   FMoH (2015) National HIV Sero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria.

[8].   Fowler MG, Lampe MA, Jamieson DJ, Kourtis AP, Rogers MF (2007). Reducing the risk of mother-to-child human immunodeficiency virus transmission: past successes, current progress and challenges, and future directions. American journal of obstetrics and gynecology. 2007; 197(3): S3-S9.

[9].   Kalua T,Barr BA, Oosterhout JJ, Mbori-Ngacha D, Schouten EJ,Gupta S,…Jahn A.(2017) Lessons Learned From Option B+ in the Evolution Toward “Test and Start” From Malawi, Cameroon, and the United Republic of Tanzania (online) https://www.msh.org/sites/msh.org/files/kalua_lessons_learned_from_option_b.pdf (Accessed 5 November,2018).

[10].  Maria F.M. Barral, Gisele R. de Oliveira, Rubens C. Lobato, Raul A. Mendoza-Sassi, Ana M. b. Martínez, and Carla V. Gonçalves (2014) Risk factors of hiv-1 vertical transmission (vt) and the influence of antiretroviral therapy (art) in pregnancy outcome. Rev Inst Med Trop Sao Paulo. 2014 Mar-Apr; 56(2): 133–138. doi: 10.1590/S0036-46652014000200008.

[11].  National Agency for the Control of AIDS (2017). National HIV and AIDS Strategic Plan 2017-2021.

[12].  Pharr JR, Obiefune MC, Ezeanolue CO, Osuji A, Ogidi, AG. Gbadamosi S… Ezeanolue EE (2016) Linkage to Care, Early Infant Diagnosis, and Perinatal Transmission among Infants Born to HIV-Infected Nigerian Mothers: Evidence from the Healthy Beginning Initiative. August 1, 2016 - Volume 72 - Issue > Linkage to Care, Early Infant Diagnosis, and Perinatal Trans...

[13].  Tindyebwa D, Kayita J, Musoke P, Eley B, Nduati R. Handbook on Paediatric AIDS in Africa. Kampala: ANECCA; 2006.

[14].  Townsend C, Cortina-Borja M, Peckham C, Lyall H, de Ruiter A, Tookey P. Very low risk of mother-to-child transmission of HIV in women on HAART achieving viral suppression in the UK and Ireland. AIDS 2008; 22:973-81.

[15].  UNAIDS (2014). The gap reports.

[16].  UNAIDS (2015) Progress report on the global plan towards elimination of new HIV infections among children and keeping their mothers alive.

[17].  UNAIDS (2018). Miles to go: Global AIDS update.

[18].  WHO (2014) Global guidance on criteria and processes for validation: elimination of mother-to-child transmission (EMTCT) of HIV and syphilis. Geneva: World Health Organization; 2014. http://apps.who.int/iris/bitstream/10665/112858/1/9789241505888_eng.pdf (Accessed 2 February, 2019).

[19].  WHO (2016). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach: 2nd Edition.