Effectiveness of option B highly active antiretroviral therapy (HAART) prevention of mother-to-child transmission (PMTCT) in pregnant HIV women

BMC Research Notes

Elijah Oyoo-Okoth³  Edward Anino⁴  Joseph K Choge¹  Eliningaya J Kweka²  Christopher Khayeka-Wandabwa⁵  Erastus K Ngemu⁴ 

[1] School of Health Sciences, University of Eastern Africa, Baraton, PO Box 2500-30100, Eldoret, Kenya;Tropical Pesticides Research Institute, Division of Livestock and Human Diseases Vector Control, Mosquito Section, Ngaramtoni, Off Nairobi road, PO Box 3024, Arusha, Tanzania;School Natural Resources and Environmental Studies, Karatina University, PO Box 1957-10101, Karatina, Kenya;School of Science, Department of Biochemistry, University of Eldoret, PO Box 1125, Eldoret, Kenya;Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya

关键词: Prevention of Mother-To-Child Transmission (PMTCT);    Mother-To-Child Transmission (MTCT);    Highly Active Antiretroviral Therapy (HAART);    Early Infant Diagnosis;    CD4 counts;    Antiretroviral;   

Others  :  1232486
DOI  :  10.1186/1756-0500-7-52

 received in 2013-04-23, accepted in 2014-01-15,  发布年份 2014

【 摘 要 】

Background

Ensuring that no baby is born with HIV is an essential step towards achieving an AIDS-free generation. To achieve this, strategies that decouple links between childbirth and HIV transmission are necessary. Traditional forms of prevention of mother-to-child transmission of HIV (PMTCT), has been recommended. Recognizing the importance and challenges of combination of methods to achieve rapid PMTCT, the World Health Organization (WHO) recommended option B Highly Active Antiretroviral Therapy (HAART) for all HIV-positive pregnant women. This study aimed to evaluate the effectiveness of the HAART in PMTCT. A cohort of HIV-infected pregnant women in Kenya were obtained from the DREAM Center, Nairobi. The study participants underwent adherence counselling and Option B of HAART [Nevirapine(NVP) + Lamivudine + Zidovudine] at the fourth week of gestation followed by an intravenous NVP administration intrapartum and postpartum NVP syrup to the respective infants for six weeks. Absolute pre-HAART and post-HAART CD4 counts and viral loads counts were determined. Comparison of the CD4 counts and viral loads before and after administration of HAART were done using Wilcoxon’s Matched Pairs Signed-Ranks Test.

Findings

The mean absolute CD4 cell counts in mothers after administration of HAART was significantly higher (Z = 15.664, p < 0.001) than before the administration of HAART). Also the viral load of the mothers significantly (Z = 11.324, p < 0.001) reduced following HAART treatment. Following the HAART administration in mothers, up to 90% of children were confirmed to be HIV negative.

Conclusion

Administration of HAART to mothers and children demonstrated an effective mechanism of PMTCT. However, other aspects of HAART such as adherence, costs, mothers behaviour during HAART, and the child feeding programme during the therapy should further be evaluated and ascertained how they can affect the overall efficacy of option B HAART in PMTCT.

【 授权许可】

   
2014 Ngemu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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