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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.
AIDS Care 2010; 22(7):843-50AC

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.

Authors+Show Affiliations

Public health, IRSS, Ouagadougou, Burkina Faso. skouanda@irss.bfNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20635248

Citation

Kouanda, Seni, et al. "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." AIDS Care, vol. 22, no. 7, 2010, pp. 843-50.
Kouanda S, Tougri H, Cisse M, et al. 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. AIDS Care. 2010;22(7):843-50.
Kouanda, S., Tougri, H., Cisse, M., Simpore, J., Pietra, V., Doulougou, B., ... Sondo, B. (2010). 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. AIDS Care, 22(7), pp. 843-50. doi:10.1080/09540120903499204.
Kouanda S, et al. 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. AIDS Care. 2010;22(7):843-50. PubMed PMID: 20635248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Kouanda,Seni, AU - Tougri,Halima, AU - Cisse,Mireille, AU - Simpore,Jacques, AU - Pietra,Virginio, AU - Doulougou,Boukare, AU - Ouedraogo,Gautier, AU - Ouedraogo,Charlemagne Marie, AU - Soudre,Robert, AU - Sondo,Blaise, PY - 2010/7/17/entrez PY - 2010/7/17/pubmed PY - 2011/6/9/medline SP - 843 EP - 50 JF - AIDS care JO - AIDS Care VL - 22 IS - 7 N2 - 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. SN - 1360-0451 UR - https://www.unboundmedicine.com/medline/citation/20635248/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_ L2 - http://www.tandfonline.com/doi/full/10.1080/09540120903499204 DB - PRIME DP - Unbound Medicine ER -