Investigation of mother-to-child transmission of HIV in pregnancy and among HIV-exposed infants accessing care at a PMTCT clinic in southwest Nigeria

Afolabi, Abosede Yetunde; Bakarey, Adeleye Solomon; Kolawole, Oladipo Elijah; Kola, Oloke Julius

doi:10.1080/15321819.2018.1494607

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…Three studies involving 433 participants reported on the MTCT rate of HBV in mother–infant pair with HBV mono-infection confirmed using PCR technique. 35 – 37 The MTCT rate for HBV were reported to be 42.86% by Onakewhor et al, 35 51.6% by Eke et al, 36 and 72.0% by Olaleye et al 37 among newborns at birth. The results of our meta-analysis revealed that the overall MTCT rates for HBV mono-infections as seen in the three included studies that reported on HBV mono-infections was 55.49% (95% CI: 35.93%–75.04%; 433 participants; three studies, I 2 = 100%; p-value < 0.001) ( Figure 4 ).…”

Section: Resultsmentioning

confidence: 97%

“…[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Majority of the studies were "retrospective cohort studies" (retrospective chart reviews) 8/18 (44.5%) 20,21,23,25,27,[32][33][34] or prospective cohort studies 6/18 (33.3%), 24,26,28,31,35,37 while only 4/18 (22.2%) were crosssectional studies. 22,29,30,36 Majority of the studies included in our meta-analysis (17/18; 94.4%) were published from 2011 to 2021 [20][21][22][23][24][25][26][27][28][29][30][31][32][33]…”

Section: Description Of Studiesmentioning

confidence: 99%

“…35 Included studies. Eighteen studies were included in a metaanalysis on rates of MTCT of HIV or HBV mono-infections, [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] as this forms the only evidence base in these viral infections of pregnancy in Nigeria (see Table 3).…”

Section: Description Of Studiesmentioning

confidence: 99%

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Mother-to-child transmission of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women with single, dual or triplex infections of human immunodeficiency virus, hepatitis B virus and hepatitis C virus in Nigeria: A systematic review and meta-analysis

et al. 2022

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Objectives: To systematically review literature and identify mother-to-child transmission rates of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among pregnant women with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria. PRISMA guidelines were employed. Searches were on 19 February 2021 in PubMed, Google Scholar and CINAHL on studies published from 1 February 2001 to 31 January 2021 using keywords: “MTCT,” “dual infection,” “triplex infection,” “HIV,” “HBV,” and “HCV.” Studies that reported mother-to-child transmission rate of at least any of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women and their infant pairs with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria irrespective of publication status or language were eligible. Data were extracted independently by two authors with disagreements resolved by a third author. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary mother-to-child transmission rates in terms of percentage with 95% confidence interval. Protocol was prospectively registered in PROSPERO: CRD42020202070. The search identified 849 reports. After screening titles and abstracts, 25 full-text articles were assessed for eligibility and 18 were included for meta-analysis. We identified one ongoing study. Pooled mother-to-child transmission rates were 2.74% (95% confidence interval: 2.48%–2.99%; 5863 participants; 15 studies) and 55.49% (95% confidence interval: 35.93%–75.04%; 433 participants; three studies), among mother–infant pairs with mono-infection of human immunodeficiency virus and hepatitis B virus, respectively, according to meta-analysis. Overall, the studies showed a moderate risk of bias. The pooled rate of mother-to-child transmission of human immunodeficiency virus was 2.74% and hepatitis B virus was 55.49% among mother–infant pairs with mono-infection of HIV and hepatitis B virus, respectively. No data exists on rates of mother-to-child transmission of hepatitis C virus on mono-infection or mother-to-child transmission of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among mother–infant pairs with dual or triplex infection of HIV, hepatitis B virus and HCV in Nigeria.

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Section: Resultsmentioning

confidence: 97%

Section: Description Of Studiesmentioning

confidence: 99%

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Mother-to-child transmission of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women with single, dual or triplex infections of human immunodeficiency virus, hepatitis B virus and hepatitis C virus in Nigeria: A systematic review and meta-analysis

et al. 2022

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“…This was attested to by other studies showing MTCT rates in excess of 20% with MF, 20 , 25 and even up to 60%. 26 Afolabi et al 27 noted MF as an important predictor in which the risk of MTCT was about two times higher compared to EBF. When infants were EBF in the first 6 months and breastfeeding continued thereafter, there was no risk of MTCT in the mother-infant pairs who received ARVs.…”

Section: Discussionmentioning

confidence: 99%

A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020

et al. 2021

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Background and Objective: Above 90% of childhood HIV infections result from mother-to child transmission (MTCT). This study examined the MTCT rates of HIV-exposed infants enrolled in the infant follow-up arm of the prevention of mother-to-child transmission (PMTCT) program in a teaching hospital in Southeast Nigeria. Methods: This was a 14-year review of outcomes of infants enrolled in the infant follow-up arm of the PMTCT program of Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. The majority of subjects were enrolled within 72 hours of birth and were followed up until 18 months of age according to the National Guidelines on HIV prevention and treatment. At enrollment, relevant data were collected prospectively, and each scheduled follow-up visit was recorded both electronically and in physical copy in the client’s folders. Data were analyzed using SPSS version 20. The major outcome variable was final MTCT status. Results: Out of 3,784 mother-infant dyads studied 3,049 (80.6%) received both maternal and infant Antiretroviral (ARV) prophylaxis while 447 (11.8%) received none. The MTCT rates were 1.4%, 9.3%, 24.1%, and 52.1% for both mother and infant, mother only, infant only, and none received ARV prophylaxis respectively. There was no gender-based difference in outcomes. The MTCT rate was significantly higher among mixed-fed infants (p<0.001) and among those who did not receive any form of ARVs (p<0.001). Among dyads who received no ARVs, breastfed infants significantly had a higher MTCT rate compared to never breastfed infants (57.9% vs. 34.8%; p<0.001). The MTCT rate was comparable among breastfed (2.5%) and never-breastfed (2.1%) dyads who had received ARVs. After logistic regression, maternal (p<0.001, OR: 7.00) and infant (p<0.001, OR: 4.00) ARV prophylaxis for PMTCT remained significantly associated with being HIV-negative. Conclusion and Global Health Implications: Appropriate use of ARVs and avoidance of mixed feeding in the first six months of life are vital to the success of PMTCT programs in developing countries. PMTCT promotes exclusive breastfeeding and reduces the burden of pediatric HIV infection, thereby enhancing child survival. Copyright © 2021 Ugochukwu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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“…Exposure to antiretroviral therapy for both the infant and mother during pregnancy and breast-feeding has been shown to reduce the risk of transmission (35) , as this reduces the viral load. Mixed feeding is also associated with higher rates of HIV transmission (Table 2 [19][20][21][22][23][28][29][30][31][32][33] ).…”

Section: Exposure Effectsmentioning

confidence: 99%

The risk of infectious pathogens in breast-feeding, donated human milk and breast milk substitutes

Blackshaw

Valtchev

Koolaji

et al. 2020

Public Health Nutr.

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Objective: This review collates the published reports that focus on microbial and viral illnesses that can be transmitted by breast milk, donor milk and powdered infant formula (PIF). In this context, we attempt to define a risk framework encompassing those hazards, exposure scenarios, vulnerability and protective factors. Design: A literature search was performed for reported cases of morbidity and mortality associated with different infant feeding modes. Setting: Exclusive breast-feeding is the recommended for infant feeding under 6 months, or failing that, provision of donated human milk. However, the use of PIF remains high despite its intrinsic and extrinsic risk of microbial contamination, as well as the potential for adverse physiological effects, including infant gut dysbiosis. Results: Viable pathogen transmission via breast-feeding or donor milk (pasteurised and unpasteurised) is rare. However, transmission of HIV and human T-cell lymphotropic virus-1 is a concern for breast-feeding mothers, particularly for mothers undertaking a mixed feeding mode (PIF and breast-feeding). In PIF, intrinsic and extrinsic microbial contamination, such as Cronobacter and Salmonella, remain significant identifiable causes of infant morbidity and mortality. Conclusions: Disease transmission through breast-feeding or donor human milk is rare, most likely owing to its complex intrinsically protective composition of human milk and protection of the infant gut lining. Contamination of PIF and the morbidity associated with this is likely underappreciated in terms of community risk. A better system of safe donor milk sharing that also establishes security of supply for non-hospitalised healthy infants in need of breast milk would reduce the reliance on PIF.

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Investigation of mother-to-child transmission of HIV in pregnancy and among HIV-exposed infants accessing care at a PMTCT clinic in southwest Nigeria

Cited by 5 publications

References 13 publications

Mother-to-child transmission of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women with single, dual or triplex infections of human immunodeficiency virus, hepatitis B virus and hepatitis C virus in Nigeria: A systematic review and meta-analysis

Mother-to-child transmission of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women with single, dual or triplex infections of human immunodeficiency virus, hepatitis B virus and hepatitis C virus in Nigeria: A systematic review and meta-analysis

A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020

The risk of infectious pathogens in breast-feeding, donated human milk and breast milk substitutes

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