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Outcome of prevention of parent-to-child transmission of HIV in an urban population in Southern India

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Abstract

Objective

To analyze the outcomes of Prevention of Parent to Child Transmission (PPTCT) of HIV program in an urban Southern Indian setting.

Design

Observational study.

Setting

Anti-retroviral Therapy (ART) Centers/ Integrated Counseling and Testing Centers (ICTC) at four government Obstetrics Institutes in an urban area.

Participants

100 HIV-positive pregnant women and their infants delivered in the study centers.

Methods

Triple drug ART to HIV-positive pregnant women was started for maternal indications only. Rest of the pregnant women were given single dose Nevirapine (200 mg) at the onset of labor. All infants were given single dose Nevirapine (2 mg/kg) prophylaxis, according to National AIDS Control Organization guidelines. Mothers were counseled regarding breastfeeding and artificial feeding, and the choice was left to them. Whole blood HIV 1 DNA PCR was done for all infants at 6 weeks of life. A second PCR was done at 6 months or 6 weeks after stopping breastfeeds. PCR-positive infants were started on ART, and were followed-up till18 months of life.

Results

Four infants were PCR-positive for HIV. All of them were breastfed. They were born to mothers of HIV stage 1 or 2 who were not on ART as CD4 counts were >350 cells/mm3. Among the mothers in Stage 3 or 4 or CD4 count <200 cells/mm3 and on ART, none of the infants was HIV-positive. The cumulative HIV-free survival at 18 months was 94%.

Conclusion

Parent-to-child transmission rate in HIV was low with the currently used strategies. Triple drug ART to mother reduces mother-to-child transmission despite advanced maternal stage or low CD4 counts.

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References

  1. Shah NK, Mamta M, Shah I, Deepak U, Lodha R, Pensi T, et al. Guidelines for HIV Care and Treatment in Infants and Children, 1st ed. New Delhi: National AIDS Control Organisation and Indian Academy of Pediatrics, 2006. p. 3–90.

    Google Scholar 

  2. Shah NK. Epidemiology and Trend of HIV in India. In: Shah I, Shah NK, Manglani M, editors. IAP Speciality Series on Pediatric HIV. 1st ed. Mumbai: Indian Academy of Pediatrics, 2006. p. 11–69.

    Google Scholar 

  3. World Health Organization, 2010. Guidelines on HIV Prevention, Treatment and Care. Available from: www.who.int/hiv/pub/en/2010guidelines. Accessed November 10, 2014.

    Google Scholar 

  4. UNAIDS. Preventing mothers from dying and babies from becoming infected by HIV. Available from: http:www.unaids.org/en/media/unaids/contest/documents/unaids publication/2010/2010103. Accessed November 10, 2014.

    Google Scholar 

  5. Jacob SM, Anitha D, Vishwanath R, Parameshwari S, Samuel NM. The use of dried blood spots on filter paper for the diagnosis of HIV-1 in infants born to HIV seropositive women. Indian J Med Microbiol. 2008;26:71–4.

    Article  PubMed  Google Scholar 

  6. Gbadegesin A, Adenibuyan OA, Adegbesan MA, Salu OB, Omilabu SA. Efficacy of HIV PCR techniques to diagnose HIV in infants born to HIV infected mothers at LASUTH. Nig Q JHosp Med. 2010;20:129–32.

    CAS  Google Scholar 

  7. Shah I. Efficacy of HIV PCR techniques to diagnose HIV in infants born to HIV infected mothers–an Indian perspective. J Assoc Physicians India. 2006;54:197–9.

    PubMed  Google Scholar 

  8. Marinda E, Humphrey JH, Iliff PJ, Mutasa K, Nathoo KJ, Piwoz EG, et al. Child mortality according to maternal and infant HIV status in Zimbabwe. Pediatr Infect Dis J. 2007;26:519–26.

    Article  PubMed  Google Scholar 

  9. Marazzi MC, Liotta G, Nielsen-Saines K, Haswell J, Magid NA, Buonomo E, et al. Extended antenatal antiretroviral use correlates with improved infant outcomes throughout the first year of life. AIDS. 2010;24:2819–26.

    Article  PubMed  Google Scholar 

  10. Ugochukwu EF, Kanu SO. Early infant diagnosis of HIV infection in southeastern Nigeria: prevalence of HIV infection among HIV-exposed babies. West Afr J Med. 2010;29:3–7.

    CAS  PubMed  Google Scholar 

  11. World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Available from: www.who.int/hiv/pub/ guidelines/arv2013/download/en. Accessed January 7, 2015.

    Google Scholar 

  12. National AIDS Control Organization. Updated Guidelines for Prevention of Parent to Child Transmission of HIV using Multi Drug Anti-retroviral Regimen in India. Available from: www.naco.gov.in/upload/NACP-IV/18022014BSD/National_Guidelines_for_PPTCT.pdf. Accessed January 7, 2015.

    Google Scholar 

  13. Thomas TK, Masaba R, Borkowf CB, Ndivo R, Zeh C, Misore A, et al. Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeedingthe Kisumu Breastfeeding Study, Kenya: a clinical trial. PLoS Med. 2011;8:e1001015.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Micek MA, Blanco AJ, Beck IA, Dross S, Matunha L, Montoya P, et al. Nevirapine resistance by timing of HIV type 1 infection in infants treated with single-dose nevirapine. Clin Infect Dis. 2010;50:1405–14.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Palombi L, Marazzi MC, Voetberg A, Magid NA. Treatment acceleration program and the experience of the DREAM program in prevention of mother-to-child transmission of HIV. AIDS. 2007; 21:S65–71.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Government Kilpauk Medical College, 28, Indra Nagar, Walajah Road, Sholinghur, Vellore, Tamilnadu, 631 102, India

    Subramani Seenivasan, Natarajan Vaitheeswaran & Viswanathan Seetha

  2. National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India

    Selvaraj Anbalagan, Ramesh Karunaianantham & Soumya Swaminathan

Authors
  1. Subramani Seenivasan
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  2. Natarajan Vaitheeswaran
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  3. Viswanathan Seetha
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  4. Selvaraj Anbalagan
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  5. Ramesh Karunaianantham
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  6. Soumya Swaminathan
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Correspondence to Subramani Seenivasan.

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Seenivasan, S., Vaitheeswaran, N., Seetha, V. et al. Outcome of prevention of parent-to-child transmission of HIV in an urban population in Southern India. Indian Pediatr 52, 759–762 (2015). https://doi.org/10.1007/s13312-015-0712-0

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  • DOI: https://doi.org/10.1007/s13312-015-0712-0

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