Pravi Moodley1, Raveen Parboosing, Dhayendre Moodley. 1. Department of Virology, National Health Laboratory Service and Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. moodleyp36@ukzn.ac.za
Abstract
OBJECTIVE: To describe a trend in perinatal HIV transmission associated with the implementation of rapidly changing prevention of mother to child transmission (PMTCT) interventions from 2004 to 2012. METHOD: Retrospective analysis of infant HIV polymerase chain reaction results of infants from 2004 to 2012 archived from a Laboratory Information System. SETTING: KwaZulu-Natal, South Africa. MAIN OUTCOME MEASURE: HIV infection in infants aged 4-8 weeks. RESULTS: The proportion of 4- to 8-week-old infants who tested HIV polymerase chain reaction positive decreased significantly (P < 0.0001) from 27.5% in 2004 to 2.9% in 2012. The reduction rates in perinatal HIV infections in 4- to 8-week-old HIV-exposed infants decreased significantly (P < 0.0001) by 48.7% following single-dose nevirapine (sdNVP) (2005 to April 2008), 68.4% with zidovudine from 28 weeks and sdNVP together with triple antiretroviral therapy for women with CD4 cell count < 200 cells/mm³ (May 2008-April 2010), and 89.5% with zidovudine from 14 weeks, sdNVP, and triple antiretroviral therapy for women with CD4⁺ cell count < 350 cells/mm³ (May 2010-December 2012). CONCLUSIONS: We show an almost 10-fold reduction in mother to child transmission from 2004 to 2012 in infants aged 4-8 weeks during a rapid implementation of more complex and robust PMTCT interventions. The significant reductions in mother to child transmission in the South African PMTCT program are encouraging for a middle-income country with the second highest antenatal HIV prevalence in the world.
OBJECTIVE: To describe a trend in perinatal HIV transmission associated with the implementation of rapidly changing prevention of mother to child transmission (PMTCT) interventions from 2004 to 2012. METHOD: Retrospective analysis of infant HIV polymerase chain reaction results of infants from 2004 to 2012 archived from a Laboratory Information System. SETTING: KwaZulu-Natal, South Africa. MAIN OUTCOME MEASURE: HIV infection in infants aged 4-8 weeks. RESULTS: The proportion of 4- to 8-week-old infants who tested HIV polymerase chain reaction positive decreased significantly (P < 0.0001) from 27.5% in 2004 to 2.9% in 2012. The reduction rates in perinatal HIV infections in 4- to 8-week-old HIV-exposed infants decreased significantly (P < 0.0001) by 48.7% following single-dose nevirapine (sdNVP) (2005 to April 2008), 68.4% with zidovudine from 28 weeks and sdNVP together with triple antiretroviral therapy for women with CD4 cell count < 200 cells/mm³ (May 2008-April 2010), and 89.5% with zidovudine from 14 weeks, sdNVP, and triple antiretroviral therapy for women with CD4⁺ cell count < 350 cells/mm³ (May 2010-December 2012). CONCLUSIONS: We show an almost 10-fold reduction in mother to child transmission from 2004 to 2012 in infants aged 4-8 weeks during a rapid implementation of more complex and robust PMTCT interventions. The significant reductions in mother to child transmission in the South African PMTCT program are encouraging for a middle-income country with the second highest antenatal HIV prevalence in the world.
Authors: Aaruni Khanolkar; William J Muller; Bridget M Simpson; Jillian Cerullo; Ruth Williams; Sun Bae Sowers; Kiana Matthews; Sara Mercader; Carole J Hickman; Richard T D'Aquila; Guorong Liu Journal: Commun Med (Lond) Date: 2022-03-04
Authors: Emily Adland; Luisa Mori; Leana Laker; Anna Csala; Maximilian Muenchhoff; Alice Swordy; Masa Mori; Philippa Matthews; Gareth Tudor-Williams; Pieter Jooste; Philip Goulder Journal: AIDS Date: 2018-07-17 Impact factor: 4.177
Authors: M Bridget Spelke; Ravi Paul; Bryan S Blette; Samantha Meltzer-Brody; Crystal E Schiller; J M Ncheka; Margaret P Kasaro; Joan T Price; Jeffrey S A Stringer; Elizabeth M Stringer Journal: J Int AIDS Soc Date: 2022-07 Impact factor: 6.707
Authors: Sarah Gimbel; Joachim Voss; Alison Rustagi; Mary Anne Mercer; Brenda Zierler; Stephen Gloyd; Maria de Joana Coutinho; Maria de Fatima Cuembelo; Kenneth Sherr Journal: J Int AIDS Soc Date: 2014-03-24 Impact factor: 5.396