| Title | Antiretroviral Treatment Initiation Among HIV-Infected Pregnant Women with Low CD4+ Cell Counts in Gaborone, Botswana. | | Author(s) | Chen JY, Ogwu AC, Svab P, Lockman S, Moffat HJ, Gaolathe T, Moilwa S, Størdal K, Dryden-Peterson S, Moffat C, Makhema J, Essex M, Shapiro RL | | Institution | From the *Harvard Medical School, Boston, MA; daggerBotswana Harvard AIDS Institute, Bontleng, Gaborone, Botswana; double daggerPrincess Marina Hospital, Gaborone, Botswana; section signBrigham and Women's Hospital, Infectious Disease Unit, Boston, MA; parallelDepartment of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA; paragraph signBotswana Ministry of Health, Health Inspectorate, Gaborone, Botswana; #Botswana Harvard PEPFAR Master Trainer Program, Gaborone, Botswana; **Infectious Disease Unit, Massachusetts General Hospital, Boston, MA; and daggerdaggerDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA. | | Source | J Acquir Immune Defic Syndr 2009 Oct 27. | | Abstract | BACKGROUND:: Botswana has the most comprehensive public program in Africa for providing antiretroviral therapy to treat HIV and prevent mother-to-child transmission (PMTCT). Botswana guidelines prioritize CD4 cell count testing during pregnancy and initiation of highly active antiretroviral treatment (HAART) for women who qualify for treatment. We analyzed rates of HIV testing, CD4 cell count testing, and HAART initiation during pregnancy.
METHODS:: From October 2007 through June 2008, we reviewed obstetric and laboratory records of women at Princess Marina Hospital in Gaborone, Botswana.
RESULTS:: We recorded information from 3056 women. Of 2675 women eligible for the PMTCT program, 2623 (98%) had a documented HIV status, of whom 793 (30%) were HIV infected. Among women who were treatment naive at pregnancy conception, 397 (59%) had recorded CD4 cell counts, of whom 62 (16%) had a CD4 cell count <200 cells per cubic millimeter. Among this subset, 23 (37%) initiated HAART during pregnancy, 26 (42%) received zidovudine prophylaxis, and 13 (21%) received no therapy.
CONCLUSIONS:: We observed low rates of CD4 cell count testing and HAART initiation during pregnancy. Antenatal clinics should prioritize CD4 cell count testing and referral of women who qualify for HAART to maximize benefits of maternal treatment and PMTCT. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19864957 |
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