BACKGROUND: Antenatal clinics are a key entry point into HIV treatment and care, together with interventions to reduce mother-to-child transmission (MTCT). Further evaluation is needed of interventions linking antenatal with antiretroviral (ARV) treatment services and effectiveness of triple-ARV regimens for reducing MTCT in resource-constrained settings. METHODS: Data were gathered from HIV-infected women attending antenatal care from June 2004 to July 2005 at Coronation Women and Children Hospital, South Africa. After a patient record review, interventions were implemented to strengthen service linkages and integrate ARV treatment within antenatal care. Laboratory investigations were streamlined, including CD4 cell count testing at the first antenatal visit. MTCT risk for women initiating ARV treatment is compared with that of women-infant pairs receiving single-dose nevirapine (sd-NVP). RESULTS: In total, 164 pregnant women initiated ARV treatment and 863 received sd-NVP. After changes to service delivery, time-to-treatment initiation was reduced from a median of 56 days to 37 days (P = 0.041). The risk of MTCT for women receiving ARV treatment (5 [4.3%] of 116 women) was lower than for those given sd-NVP (74 [10.7%] of 692 women; P = 0.032). CONCLUSIONS: Strengthening linkages and integrating key components of ARV treatment within antenatal care reduces time-to-treatment initiation. In this setting, among women with a high MTCT risk, triple-ARV regimens are effective in reducing HIV infection in infants.
BACKGROUND: Antenatal clinics are a key entry point into HIV treatment and care, together with interventions to reduce mother-to-child transmission (MTCT). Further evaluation is needed of interventions linking antenatal with antiretroviral (ARV) treatment services and effectiveness of triple-ARV regimens for reducing MTCT in resource-constrained settings. METHODS: Data were gathered from HIV-infectedwomen attending antenatal care from June 2004 to July 2005 at Coronation Women and Children Hospital, South Africa. After a patient record review, interventions were implemented to strengthen service linkages and integrate ARV treatment within antenatal care. Laboratory investigations were streamlined, including CD4 cell count testing at the first antenatal visit. MTCT risk for women initiating ARV treatment is compared with that of women-infant pairs receiving single-dose nevirapine (sd-NVP). RESULTS: In total, 164 pregnant women initiated ARV treatment and 863 received sd-NVP. After changes to service delivery, time-to-treatment initiation was reduced from a median of 56 days to 37 days (P = 0.041). The risk of MTCT for women receiving ARV treatment (5 [4.3%] of 116 women) was lower than for those given sd-NVP (74 [10.7%] of 692 women; P = 0.032). CONCLUSIONS: Strengthening linkages and integrating key components of ARV treatment within antenatal care reduces time-to-treatment initiation. In this setting, among women with a high MTCT risk, triple-ARV regimens are effective in reducing HIV infection in infants.
Authors: Risa M Hoffman; Vivian Black; Karl Technau; Karin Joan van der Merwe; Judith Currier; Ashraf Coovadia; Matthew Chersich Journal: J Acquir Immune Defic Syndr Date: 2010-05-01 Impact factor: 3.731
Authors: Baotran N Vo; Craig R Cohen; Rachel M Smith; Elizabeth A Bukusi; Maricianah A Onono; Katie Schwartz; Sierra Washington; Janet M Turan Journal: AIDS Care Date: 2012-02-01
Authors: Amitabh B Suthar; David Hoos; Alba Beqiri; Karl Lorenz-Dehne; Craig McClure; Chris Duncombe Journal: Bull World Health Organ Date: 2012-11-28 Impact factor: 9.408
Authors: Janet M Turan; Rachel L Steinfeld; Maricianah Onono; Elizabeth A Bukusi; Meghan Woods; Starley B Shade; Sierra Washington; Reson Marima; Jeremy Penner; Marta L Ackers; Dorothy Mbori-Ngacha; Craig R Cohen Journal: PLoS One Date: 2012-09-06 Impact factor: 3.240