Prevention of Parent to Child Transmission of HIV: Single Centre Experience of 14 years at Tertiary Care Hospital in Delhi, India

Radhika, A. G.; Chawla, Sonia; Bhaskaran, Sruthi

doi:10.7860/jcdr/2017/26432.10423

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…The rate of parent to child transmission in our study was 2.56% with only 1 baby out of 39 tested positive at 6 weeks by DNA PCR. This was comparable to 3.3% observed by Dadhwal et al and 3.4% by Radhika et al 14,19 Only 1.92% babies were positive in study done by Gautam et al while as low as 0.7% were positive in study by Girma et al 15,20 Out of 39 infants in our study, no neonatal mortality was reported. Only 1 infant (2.5%) died at 4 months of age due to pneumonia; this was the only infant who tested positive at 6 weeks.…”

Section: Discussionsupporting

confidence: 86%

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Effect of triple drug antiretroviral therapy on CD4+ count in pregnant women with HIV and prevention of parent to child transmission

Dwivedi

Gupta

Agarwal

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Background: India has moved from single drug Antiretroviral Therapy (ART) in 2002 to triple drug ART in 2013 to prevent parent to child transmission of HIV. The aim of the study was to know the effects of triple drug ART on maternal CD4+ count and prevention of HIV transmission to baby along with its adherence, side effects and pregnancy outcome.Methods: A prospective study wsas done in Safdarjung Hospital, New Delhi on 40 HIV positive pregnant women who received single dose combination of triple drug ART. CD4+ count, LFT and KFT were done before beginning of ART and repeated after 6 months of ART. The infants received nevirapine prophylaxis and HIV status was determined by DBS PCR at 6 weeks.Results: The median CD4+ count was 317 and 397 pre and post ART for 6 months respectively (p value<0.001. Low birth weight (LBW) was seen in 43.59% which was statistically significant but confounded as 76.4% of these babies were preterm. 23.08% of babies had an APGAR of < 7 at 1 minute, out of which 77.7% were preterm. Nine out of 39 infants (one had abortion) needed NICU admission. Only one baby (2.56%) was HIV positive who died at 4 months of age due to pneumonia. There was no defaulter and no statistically significant changes in LFT and KFT after 6 months of ART.Conclusions: Triple drug ART offers greater convenience improves fetomaternal outcome and minimize the risk of HIV transmission from mother to child.

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Section: Discussionsupporting

confidence: 86%

“…16 On the contrary, Dadhwal et al and Radhika et al had 83.9% and 63.9% of their subjects chose top-feeding. 14,19 The decision of breastfeeding versus top-feeding differed depending upon study period because breastfeeding is now being promoted under WHO B+ regimen treatment for HIV.…”

Section: Discussionmentioning

confidence: 99%

Effect of triple drug antiretroviral therapy on CD4+ count in pregnant women with HIV and prevention of parent to child transmission

Dwivedi

Gupta

Agarwal

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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“…Most were in the 20-25 year age group, with 13.45% being under 20, thus it is imperative that knowledge about HIV and modes of spread be imparted from a younger age, along with sex education and safe sex practices, through mass media and awareness campaigns. [6][7][8] As seen in our study, Mohite et al, also reported an increase in the acceptance rate of pretest counseling and HIV testing, from 88.9% to 100% over 10 years. 9 The seroprevalence rate in our study was low compared to other studies, as shown in Table 4.…”

Section: Resultssupporting

confidence: 78%

“…In a study done by Shiradkar et al, 10.29% of seropositive women had an abortion and caesarean section rates declined from 50% to 31% from 2002 to 2011. 6 In a study done by Kwatra Stillbirth rate in our study was 3.23%, compared to 6.9% reported by Radhika et al, and 2% by Potty et al 8,16 There were 96.77% live births in our study as compared to 93.91% in the study done by Kwatra et al, and 93.12% reported by Shiradkar et al 6,7 We reported 100% ART coverage of antenatally registered HIV-positive pregnant women at our institute, 2013 onwards, which surpasses the target of >95% set by the WHO.…”

Section: Resultscontrasting

confidence: 45%

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HIV in pregnancy: a 9 year study of the seroprevalence, sociodemographic factors and pregnancy outcomes of seropositive women at a tertiary care hospital in Mumbai, Maharashtra, India

Fonseca

Mehta

2019

Int J Reprod Contracept Obstet Gynecol

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Background: HIV can cause considerable morbidity and mortality in those affected. An effective PPTCT programme helps in reducing the spread of HIV by vertical transmission and improving the life of the women and her baby.Methods: A retrospective study was done at a tertiary care hospital, including pregnant women registered and delivered at the hospital during a period of 9 years from January 2010 to December 2018. Pretest counseling, HIV testing, Post-test counseling were done and antiretroviral prophylaxis given as per the NACP guidelines. Sociodemographic characteristics, obstetric and maternal-foetal outcome of seropositive women and efficacy of PPTCT services were analyzed.Results: Out of the 58,205 antenatal mothers included, 55,256 (94.93%) accepted HIV testing. 171 of these tested positive (0.31%). 70 spouses of the 171 seropositive women tested positive, 53 tested negative and 48 did not undergo the HIV test. Majority of seropositive women were primigravidas; housewives from urban areas, from low income and educational background and with no history of any contraceptive use. 7.6% had an MTP, 1.75% a spontaneous abortion and 0.58% an ectopic pregnancy. Of the 154 births, 35.71% underwent caesarean sections. There were 96.7% live births in our study and the perinatal mortality rate was 5.19%. After 2013, all mother-baby pairs were given ARV prophylaxis.Conclusions: Utilization of PPTCT services has increased through the years, decreasing the vertical transmission and seroprevalence rate. Increasing the acceptance rates of HIV testing, both by patients and partners may further help in curbing the spread of this condition.

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Seroprevalence and Efficacy of Prevention of Parent to Child Transmission Program Over a Decade in a Tertiary Care Hospital in Mumbai, Maharashtra

Kapote

Fonseca

Nayak

et al. 2021

J Obstet Gynecol India

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Background Parent to child transmission is the major mode of spread of HIV. An effective national health program (PPTCT) has been designed under NACO which helps in reducing the spread of HIV by vertical transmission and improving the life of the women and her baby. Methods A retrospective study was done at a tertiary care hospital, including pregnant women registered and delivered, and those who came directly in labour at the hospital during a period of 10 years from January 2010 to December 2019. Pretest counselling, HIV testing, Post-test counselling were done, and antiretroviral prophylaxis was given as per the NACP guidelines. Sociodemographic characteristics, obstetric outcome and efficacy of PPTCT services were analysed. Results Out of the 63,947 antenatal mothers included, 61,061 (95.4%) accepted HIV testing. 177 of these tested positive (0.289%) with a significant reduction in the seroprevalence over the decade. Majority of seropositive women were primigravida; housewives from urban areas, from low income and educational background and with no history of any contraceptive use. Out of 718 live births, the MTCT rate was found to be 4.5% at 6 weeks over the whole decade and was noted to be 1.8 % at 18 months which is well within the goal of PPTCT program and hence elucidating the success. Seventy-four spouses of the 177 seropositive women tested positive, 55 tested negative and 49 did not undergo the HIV testing. Decline in the number of partners not undergoing testing was elicited. The discordant couple rate in the study was 31% and showed variable trend over the decade. Conclusions Our study has observed an overall increase in efficacy of PPTCT in terms of increased utilization of PPTCT through the decade, decrease in the vertical transmission and seroprevalence rate, increase in the acceptance rates of HIV testing by partner almost conquering the goal of NACO.

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Prevention of Parent to Child Transmission of HIV: Single Centre Experience of 14 years at Tertiary Care Hospital in Delhi, India

Abstract: The study highlights the practical aspects of policy implementation and operational issues involved in low resource country.

Cited by 5 publications

References 18 publications

Effect of triple drug antiretroviral therapy on CD4+ count in pregnant women with HIV and prevention of parent to child transmission

Effect of triple drug antiretroviral therapy on CD4+ count in pregnant women with HIV and prevention of parent to child transmission

HIV in pregnancy: a 9 year study of the seroprevalence, sociodemographic factors and pregnancy outcomes of seropositive women at a tertiary care hospital in Mumbai, Maharashtra, India

Seroprevalence and Efficacy of Prevention of Parent to Child Transmission Program Over a Decade in a Tertiary Care Hospital in Mumbai, Maharashtra

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