Determinants of mother to child transmission of HIV among HIV exposed infants managed in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Abstract

Background: Mother to child transmission of HIV (MTCT) is globally known to be the major route of spread of HIV to the unborn fetus and neonate. Many factors related to the mother, infant or the type of HIV virus interplay to increase the risk of MTCT of the virus. Antepartum antiretroviral drugs administration reduces the maternal viral load therefore lowering the risk of transmission. The objective is to determine infection rate and assess determinants of MTCT of HIV exposed infants delivered in UDUTH Sokoto.Methods: It was a 5-year retrospective study. Records of all HIV positive pregnant women and their babies managed in UDUTH were reviewed from the E health system of the hospital. Patient’s details were recorded from booking to delivery for the period under study. The infant’s records were retrieved and information from delivery to 18 months post-delivery obtained. Structured data collection tool was developed to compile the required information. Data was analyzed using SPSS IBMS 22. Descriptive statistics and comparisons between variables were made statistically using Chi square. P value of ≤ 0.005 was considered as significant.Results: Records of all the patients recruited were all available for evaluation because authors use the E-health system of records keeping in our hospital. MTCT rate was 0.92%. Majority 60 (47.2%) were within age group 26-30yrs. The subjects were predominantly house wives 97(71.4%) and multipara 77 (60.6%). Viral load ranged between 112 to 28228 copies/ml. Twenty-two (17.3%) had CD4 count less than 250 cells/µl while 61 (48%) had counts above 500cells/µl. All were in WHO clinical stage 1-3. All were on triple regimen anti-retroviral drugs. Spontaneous rupture of membranes for over 4 hours occurred in 51(32%). Vaginal delivery was recorded in 89.7%. Breast feeding was practiced by 48%.Conclusions: Breast-feeding still remains a risk factor for MTCT OF HIV Early administration of maternal antiretroviral drugs significantly reduces the rate of mother to child transmission of HIV.

Fatores associados à transmissão vertical do HIV em pacientes assistidas em um serviço de referência na Paraíba: um estudo caso-controle / Factors associated with vertical transmission of HIV in patients assisted in a reference service in Paraíba: a case-control study

“…Algumas pesquisas (MAIRO et al, 2018;GOUVÊA, 2015) que abordam a transmissão vertical do HIV revelam que o uso da TARV durante gestação e parto reduz significativamente o risco de transmissão para a criança, o que pode ser observado nos dados deste estudo, visto que houve menos contaminação dentre as mães que fizeram uso do TARV.…”

“…No presente estudo, apenas metade das mulheres em condição de transmissão vertical fez uso de AZT intraparto. Os principais fatores de risco para a transmissão vertical do HIV incluem falha na terapia antirretroviral, diagnóstico tardio materno e não uso de AZT intraparto, tendo como consequência a alta carga viral das mães no momento do parto (SANTOS, et al, 2017;MAIRO et al, 2018).…”

“…Entretanto, 14,8% das crianças com sorologia positiva tiveram alimentação mista, o que foi estatisticamente significativo para o aumento da transmissão vertical, tendo em vista que a prática do não aleitamento materno é de suma importância para a redução da infecção, como também evidenciam outros estudos (TORRES; LUZ, 2017;MAIRO et al, 2018).…”