HIV-1 mother-to-child transmission, post-test counselling, and antiretroviral prophylaxis in Northern Viet Nam: A prospective observational study

Ha, Tran Thi Thanh; Anh, Nguyễn Mai; Bao, Nguyen Huy; Tuan, Pham Le; Caridha, Rozina; Gaseitsiwe, Simani; Hiển, Nguyễn Trần; Cam, Phung Dac; Ehrnst, Anneka

doi:10.3109/00365548.2012.690160

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…The Thai Nguyen study showed higher survival rate among HIV-negative infants (100%) compared with HIV-positive or unknown HIV-status infants (87%) at 12 months of age. This is consistent with another study from Vietnam [ 21 ], which demonstrated that no HIV-negative infants died in the first 12 months of their lives. Factors that increased mortality risk among HIV-exposed infants reported in several studies [ 23 - 26 ] were maternal death, maternal high viral load and low CD4 count, and infant HIV infection.…”

Section: Discussionsupporting

confidence: 93%

“…Late maternal HIV diagnosis, high maternal viral load and low CD4 count, breastfeeding, vaginal delivery, and invasive procedure are documented risk factors for mother-to-child HIV transmission [ 16 - 20 ]. In our univariate analysis, education level, ethnicity, living area, and employment status were not associated with infant HIV status, although a study in Vietnam found an association between young age of the mothers (<25) and HIV transmission [ 21 ]. It is important to note that key effective interventions, including time of early HIV diagnosis, access to ARVs for mothers and infants, and infant formula feeding, were associated with low risk for HIV transmission.…”

Section: Discussionmentioning

confidence: 92%

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Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data

Nguyen¹,

Sabin²,

et al. 2017

JMIR Public Health Surveill

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BackgroundThe prevention of mother-to-child transmission (PMTCT) of HIV program was introduced in Vietnam in 2005. Despite the scaling up of PMTCT programs, the rate of mother-to-child HIV transmission in Vietnam was estimated as high as 20% in 2013.ObjectiveThe objective of this study was to assess the outcomes of PMTCT and identified factors associated with mother-to-child transmission and infant survival using survey and program data in a high HIV burden province in Vietnam.MethodsThis community-based retrospective cohort study observed pregnant women diagnosed with HIV infection in Thai Nguyen province from October 2008 to December 2012. Data were collected through interviews using a structured questionnaire and through reviews of log books and medical charts in antenatal care and HIV clinics. Logistic regression and survival analysis were used to analyze data using Stata (StataCorp).ResultsA total of 172 pregnant women living with HIV were identified between 2008 and 2012. Most of these women had acquired the HIV infection from their husband (77/119, 64.7%). Significant improvement in the PMTCT program was documented, including reduction in late diagnosis of HIV for pregnant women from 62.5% in 2008 to 30% in 2012. Access to antiretrovirals (ARVs) improved, increasing from a rate of 18.2% (2008) to 70.0% (2011) for mothers and from 36.4% (2008) to 93.3% (2012) for infants. For infants, early diagnosis within 2 months of birth reached 66.7% in 2012 compared with 16.7% in 2009. Transmission rate reduced from 27.3% in 2008 to 6.7% in 2012. Late diagnosis was associated with increased risk for HIV transmission (odds ratio [OR] 14.7, 95% CI 1.8-121.4, P=.01), whereas ARV therapy for mother and infant in combination with infant formula feeding were associated with reduced risk for HIV transmission (OR 0.01, 95% CI 0.001-0.1; P<.001). Overall survival rate for HIV-exposed infants at 12 months was 97.7%.ConclusionsA combination of program and survey data measured the impact of prevention of HIV transmission from mother-to-child interventions. Significant improvement in access to the interventions was documented in Thai Nguyen province. However, factors that increased the risk of HIV transmission, such as late diagnosis, remain to be addressed.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 92%

Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data

Nguyen¹,

Sabin²,

et al. 2017

JMIR Public Health Surveill

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“…This will maintain an optimum microbiome which will contribute resistance to HIV. However, in many Asian countries, if the mother is HIV positive, the infant is started on infant formula after birth as, for example, in Vietnam [52].…”

Section: Hiv Infectionmentioning

confidence: 99%

Breastfeeding and the Risk of Infant Illness in Asia: A Review

Lee

Binns

2019

IJERPH

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Infancy remains the most vulnerable period of human life for death, illness, and establishing a lifetime trajectory of growth and health. It is estimated that there are 5.3 million deaths under five years of age worldwide and approximately 800,000 lives could be saved by improving breastfeeding rates and duration. In Asia, an estimated 300,000–350,000 child deaths could be prevented with optimal breastfeeding and the majority would be under 12 months of age. We present a systematic review of studies of infection and breastfeeding in infants in Asia and further review interactions of selected infectious diseases and breastfeeding. Initially, 2459 records of possible interest were identified, 153 full text papers were reviewed in detail, and 13 papers describing diarrhoeal disease and/or acute respiratory tract infection were selected for inclusion in the review. Additional papers were selected to discuss specific diseases and their relationship to breastfeeding. The review found that a variety of methods were used with differing definitions of breastfeeding and diseases. Overall, breastfeeding when compared to the use of infant formula, is associated with significantly lower rates of diarrhoeal disease and lower respiratory tract infection, with a reduction of 50% or more to be expected, especially in infants under six months of age. The relationship between breastfeeding and specific diseases including measles and HTLV1 were reviewed. Breastfeeding reduces some disease rates, but there remain a few conditions where breastfeeding may be contra-indicated.

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“…22 Blood samples were collected from the mothers on the day of delivery and from their infants within 1-2 days after birth between 2004 and 2006. Blood samples were also collected from the infants 1, 3, 6, and/or 12 months after birth, although some mother-and-child pairs, especially those who lived far from the hospital, could not come to the hospital at all the sample collection times.…”

Section: Study Subjectsmentioning

confidence: 99%

“…18 MTCT of HIV-1 was observed in nine (6.7%) of the 135 children, who were all on single-dose nevirapine prophylaxis and were born to mothers with and without ARV prophylaxis between 2004 and 2006 in Northern Vietnam. 22 However, limited data are available on the factors associated with vertical transmission of HIV-1, such as the transmission of drug-resistant HIV-1 and selection based on coreceptor usage in Vietnam.…”

Section: Introductionmentioning

confidence: 99%

Genetic Analyses of HIV-1 Strains Transmitted from Mother to Child in Northern Vietnam

Phan

Pham

et al. 2015

AIDS Research and Human Retroviruses

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We previously reported mother-to-child transmission of HIV-1 in nine (6.7%) of 135 children on nevirapine prophylaxis in Vietnam. In the current study, we investigated the appearance and profile of antiretroviral drug (ARV) resistance mutations, the predicted coreceptor usage, and the genetic diversity of HIV-1 strains isolated from the eight pairs of HIV-1-infected mothers and their children, who were followed up to 12 months after birth. Portions of the pol and env C2V3 regions of the HIV-1 strains were analyzed genetically. HIV-1 CRF01_AE RNA was detected in four (50%) children at delivery. Y181C, a nevirapine resistance mutation, appeared in two (25%) children 1 and 3 months after birth, respectively. No ARV resistance mutation was detected in the mothers, though three mothers were on ARV prophylaxis. Five mothers and their children harbored CCR5-tropic (R5) viruses. Two mothers harbored both R5 and CXCR4-tropic (X4) viruses, but their children harbored only R5 viruses even though the X4 viruses were dominant in the mothers. In the remaining one mother, HIV-1 RNA was not amplified and her child harbored both R5 and X4 viruses at birth, but only X4 virus 12 months after delivery. The infants' viruses were more homogeneous than their mothers' viruses (mean distance: 0.5% vs.

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HIV-1 mother-to-child transmission, post-test counselling, and antiretroviral prophylaxis in Northern Viet Nam: A prospective observational study

Cited by 4 publications

References 28 publications

Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data

Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data

Breastfeeding and the Risk of Infant Illness in Asia: A Review

Genetic Analyses of HIV-1 Strains Transmitted from Mother to Child in Northern Vietnam

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