Review of uptake of interventions to reduce mother to child transmission of HIV by women aware of their HIV status

Publisher Website
Google Scholar
Abstract
Objectives: To examine the change in uptake of interventions to reduce transmission of HIV from mothers to infants from January 1994 to July 1997. Design: Review of mother-infant pairs who presented for infant diagnosis of HIV infection. Setting: Central London hospital with facilities for diagnosis of infant HIV infection. Subjects: 57 consecutive mother-infant pairs, mainly from central London but also referred from surrounding hospitals. Interventions: Data were collected on mother's country of origin; CD4 count at delivery; plasma HIV RNA copies/ml; mode of delivery; antiretroviral therapy; infant feeding; and HIV infection in infants. Main outcome measures: HIV infection of infants. Results: The vertical transmission rate was 12% (7 pairs; 95% confidence interval 3% to 22%). All mothers chose not to breast feed. The caesarean section rate was 53% (30/57). Antiretroviral therapy was taken by 68.5% (39/57) of mother-infant pairs. With antiretroviral therapy or caesarean section, or both, transmission occurred in 6% (0% to 13%) of pairs (3/50). During the 24 months of 1994 and 1995, 21% (4/19) of infants were infected with HIV; 7.9% (3/38) were infected over the 19 months January 1996 to July 1997. The caesarean section rate did not change over these periods. Use of antiretroviral therapy increased from 31.5% (6/19) to 86.8% (33/38) (PConclusion: Women with a diagnosis of HIV infection acted to reduce the risk of transmission to their infants. Uptake of antiretroviral therapy increased significantly over time, and the caesarean section rate was persistently high. In this London cohort, pregnant women who knew they had HIV all acted to reduce vertical transmission No mothers breast fed, and about half chose to have a caesarean section Mothers' use of antiretroviral therapy increased from 32% in 1994–5 to 87% in 1996-7 With antiretroviral therapy or caesarean section, or both, vertical transmission occurred in 6% of mother-infant pairs Improving uptake of antenatal testing for HIV continues to be important

This publication has 0 references indexed in Scilit: