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The impact of maternal highly active antiretroviral therapy and short-course combination antiretrovirals for prevention of mother-to-child transmission on early infant infection rates at the Mulago national referral hospital in Kampala, Uganda, January 2007 to May 2009.
J Acquir Immune Defic Syndr 2011; 56(1):69-75JA

Abstract

BACKGROUND

Early HIV infant diagnosis and treatment have been shown to dramatically improve survival in infants. Despite these findings, infants accessing HIV diagnosis and treatment remain low in Uganda. We describe the antiretroviral (ARV) drugs given in the Mulago Hospital prevention of mother-to-child transmission (PMTCT) program from January 2007 to May 2009 and its impact on early infant HIV infection rates.

METHODS

Pregnant women identified as HIV infected in the Mulago antenatal clinics received one of the following regimens: short-course ARV prophylaxis plus single-dose nevirapine (sdNVP) in labor, highly active antiretroviral therapy (HAART), or sdNVP if they presented in labor. Infants received sdNVP and zidovudine (ZDV) for 1 week. Infants HIV diagnosis was done from 6 weeks after delivery.

RESULTS

62.3% of HIV-infected women received combination ARVs, including HAART. Early infection rates were highest among infants with no maternal ARV [36.4; 95% confidence interval (CI): 17.2 to 59.3] or only sdNVP (11.2; 95% CI: 8.1 to 14.8). Similar rates were observed for the group that took short-course ARVs, ZDV/sdNVP (4.6; 95% CI: 3.2 to 6.4), and ZDV/lamivudine/sdNVP (4.9; 95% CI: 3.1 to 7.2) and lowest rates for those that took HAART (1.7: 95% CI: 0.8 to 2.8). Overall infection rate was 5.0% (95% CI: 4.1 to 5.9).

CONCLUSIONS

Findings indicate low rates of infant infection for mothers receiving combination ARVs. These findings demonstrate that provision of combination ARV for PMTCT is feasible and effective in busy referral hospital's PMTCT programs in resource-limited settings.

Authors+Show Affiliations

Makerere University Johns Hopkins Research Collaboration, Mulago Hospital, Uganda. znamukwaya@mujhu.orgNo 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21099692

Citation

Namukwaya, Zikulah, et al. "The Impact of Maternal Highly Active Antiretroviral Therapy and Short-course Combination Antiretrovirals for Prevention of Mother-to-child Transmission On Early Infant Infection Rates at the Mulago National Referral Hospital in Kampala, Uganda, January 2007 to May 2009." Journal of Acquired Immune Deficiency Syndromes (1999), vol. 56, no. 1, 2011, pp. 69-75.
Namukwaya Z, Mudiope P, Kekitiinwa A, et al. The impact of maternal highly active antiretroviral therapy and short-course combination antiretrovirals for prevention of mother-to-child transmission on early infant infection rates at the Mulago national referral hospital in Kampala, Uganda, January 2007 to May 2009. J Acquir Immune Defic Syndr. 2011;56(1):69-75.
Namukwaya, Z., Mudiope, P., Kekitiinwa, A., Musoke, P., Matovu, J., Kayma, S., ... Fowler, M. G. (2011). The impact of maternal highly active antiretroviral therapy and short-course combination antiretrovirals for prevention of mother-to-child transmission on early infant infection rates at the Mulago national referral hospital in Kampala, Uganda, January 2007 to May 2009. Journal of Acquired Immune Deficiency Syndromes (1999), 56(1), pp. 69-75. doi:10.1097/QAI.0b013e3181fdb4a8.
Namukwaya Z, et al. The Impact of Maternal Highly Active Antiretroviral Therapy and Short-course Combination Antiretrovirals for Prevention of Mother-to-child Transmission On Early Infant Infection Rates at the Mulago National Referral Hospital in Kampala, Uganda, January 2007 to May 2009. J Acquir Immune Defic Syndr. 2011 Jan 1;56(1):69-75. PubMed PMID: 21099692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of maternal highly active antiretroviral therapy and short-course combination antiretrovirals for prevention of mother-to-child transmission on early infant infection rates at the Mulago national referral hospital in Kampala, Uganda, January 2007 to May 2009. AU - Namukwaya,Zikulah, AU - Mudiope,Peter, AU - Kekitiinwa,Adeodata, AU - Musoke,Philippa, AU - Matovu,Joyce, AU - Kayma,Sarah, AU - Salmond,William, AU - Bitarakwate,Edward, AU - Mubiru,Michael, AU - Maganda,Albert, AU - Galla,Moses, AU - Byamugisha,Josaphat, AU - Fowler,Mary Glenn, PY - 2010/11/25/entrez PY - 2010/11/26/pubmed PY - 2011/1/12/medline SP - 69 EP - 75 JF - Journal of acquired immune deficiency syndromes (1999) JO - J. Acquir. Immune Defic. Syndr. VL - 56 IS - 1 N2 - BACKGROUND: Early HIV infant diagnosis and treatment have been shown to dramatically improve survival in infants. Despite these findings, infants accessing HIV diagnosis and treatment remain low in Uganda. We describe the antiretroviral (ARV) drugs given in the Mulago Hospital prevention of mother-to-child transmission (PMTCT) program from January 2007 to May 2009 and its impact on early infant HIV infection rates. METHODS: Pregnant women identified as HIV infected in the Mulago antenatal clinics received one of the following regimens: short-course ARV prophylaxis plus single-dose nevirapine (sdNVP) in labor, highly active antiretroviral therapy (HAART), or sdNVP if they presented in labor. Infants received sdNVP and zidovudine (ZDV) for 1 week. Infants HIV diagnosis was done from 6 weeks after delivery. RESULTS: 62.3% of HIV-infected women received combination ARVs, including HAART. Early infection rates were highest among infants with no maternal ARV [36.4; 95% confidence interval (CI): 17.2 to 59.3] or only sdNVP (11.2; 95% CI: 8.1 to 14.8). Similar rates were observed for the group that took short-course ARVs, ZDV/sdNVP (4.6; 95% CI: 3.2 to 6.4), and ZDV/lamivudine/sdNVP (4.9; 95% CI: 3.1 to 7.2) and lowest rates for those that took HAART (1.7: 95% CI: 0.8 to 2.8). Overall infection rate was 5.0% (95% CI: 4.1 to 5.9). CONCLUSIONS: Findings indicate low rates of infant infection for mothers receiving combination ARVs. These findings demonstrate that provision of combination ARV for PMTCT is feasible and effective in busy referral hospital's PMTCT programs in resource-limited settings. SN - 1944-7884 UR - https://www.unboundmedicine.com/medline/citation/21099692/The_impact_of_maternal_highly_active_antiretroviral_therapy_and_short_course_combination_antiretrovirals_for_prevention_of_mother_to_child_transmission_on_early_infant_infection_rates_at_the_Mulago_national_referral_hospital_in_Kampala_Uganda_January_2007_to_May_2009_ L2 - http://dx.doi.org/10.1097/QAI.0b013e3181fdb4a8 DB - PRIME DP - Unbound Medicine ER -