Effective program against mother‐to‐child transmission of HIV at Saint Camille Medical Centre in Burkina Faso

Abstract

The present research was aimed to prevent mother-to-child transmission of HIV; to use RT-PCR in order to detect, 6 months after birth, infected children; and to test the antiretroviral resistance of both children and mothers in order to offer them a suitable therapy. At the Saint Camille Medical Centre, 3,127 pregnant women (aged 15-44 years) accepted to be enrolled in the mother-to-child transmission prevention protocol that envisages: (i) Voluntary Counselling and Testing for all the pregnant women; (ii) Antiretroviral therapy for HIV positive pregnant women and for their newborns; (iii) either powdered milk feeding or short breast-feeding and RT-PCR test for their children; (iv) finally, pol gene sequencing and antiretroviral resistance identifications among HIV positive mothers and children. Among the patients, 227/3,127 HIV seropositive women were found: 221/227 HIV-1, 4/227 HIV-2, and 2/227 mixed HIV infections. The RT-PCR test allowed the detection of 3/213 (1.4%) HIV infected children: 0/109 (0%) from mothers under ARV therapy and 3/104 (2.8%) from mothers treated with Nevirapine. All children had recombinant HIV-1 strain (CRF06_CPX) with: minor PR mutations (M36I, K20I) and RT mutations (R211K). Among them, two twins had Non-Nucleoside Reverse Transcriptase Inhibitor mutation (Y18CY). Both mothers acquired a major PR mutation (V8IV), investigated 6 months after a single-dose of Nevirapine. Prevention by single-dose of Nevirapine reduced significantly mother-to-child transmission of HIV, but caused many mutations and resistance to antiretroviral drugs. Based on present study the antiretroviral therapy protocol, together with the artificial-feeding, might represent the ideal strategy to avoid transmission of HIV from mother-to-child.

Towards the complete eradication of mother-to-child HIV/HBV coinfection at Saint Camille Medical Centre in Burkina Faso, Africa

“…1,16,17 The results obtained in this study show that the MTCT-HIV is feasible in Saint Camille Medical Centre in Ouagadougou (CMSC) and in all the territory of Burkina Faso. In fact, in our present research, the rate of vertical transmission of HIV is 0/115 (0.0%) ( 24 in India (9.9%).…”

“…It is one of the Sub-Saharan African countries that are more struck by the HIV/AIDS and HBV infection. 1,2 Among the modes of infection of the Human Immunodefi ciency Virus (HIV) and Hepatitis B Virus (HBV), the mother-tochild vertical transmission (MTCT) is a wellestablished fact. 34 This transmission is carried out in the intrauterine life by mother-foetal micro-transfusion, during the delivery by contact with maternal blood and vaginal secretions, or during breast feeding.…”

Antimicrobial resistance of abnormal vaginal discharges microorganisms in Ouagadougou, Burkina Faso

“…Since 2000, the centre has made the fight against infections affecting pregnant women one of its main goals. Recorded studies to date revealed that many women attending antenatal clinics were co-infected with Toxoplasma gondii and viruses including HHV-8, HBV, HCV and HIV [6][7][8] . More recently, it was found that the Papillomavirus took an important part in these infections and that the strains circulating in Burkina Faso were not all covered by vaccines available in the country [9,10] .…”

“…The main reason is that the presence of these pathogens in a patient weakens the placental barrier to let pass one or the other viruses [6,11] . However, no studies have been conducted in the centre to check the incidence of bacterial and fungal strains that can infect the vaginal tract.…”

Antiretroviral (ARV) Therapy in Resource Poor Countries: What do we Need in Real Life?

“…Pregnancy and lactation: (i) the use of first-line regimens containing NNRTI in countries with high fertility rates may expose to the risk of teratogenicity (efavirenz) or hypersensitivity reactions (nevirapine); (ii) the advocated earlier criteria for HAART in pregnancy [14] will have a favorable impact on vertical HIV transmission [15], but will probably enhance the risk of viral resistance; (iii) the risk of perinatal transmission via lactation requires innovative strategies, including HAART during the lactation period irrespective of maternal criteria to start HAART [16].…”