A Study on Maternal Viral Load, CD4+cell Counts and Time of Mother to Child Transmission of Human Immunodeficiency Virus Type 1 at Adama and Asella Hospitals, Ethiopia.
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Date
2012-06
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Addis Ababa University
Abstract
Background: Human immunodeficiency virus (HIV) is an etiologic agent of AIDS in human. Vertical transmission among women who had no access to ARV treatment was estimated to be15-20% in Europe, 25-30% in America and 25-35% in Africa. Vertical transmission is one of the modes of HIV transmission with the rate of 10% in Ethiopia.
Objective: The aim of this study was to determine the proportions and time of MTCT of HIV-1 and to evaluate the efficacy of ARV/ HAART on prevention of MTCT of HIV-1 in the study areas.
Methods: Prospective cohort study design was conducted from November, 2011 to May 22, 2012. A convenient sampling technique was used to recruit the study participants. 24 non breastfeeding and 57 breastfeeding mother-infant pairs were involved in this study. Maternal venous blood and infant dried blood spot were collected; then, processed in Adama Regional laboratory. Maternal socio-demographic data were collected by using structured interviewer administered questionnaire. All data were entered into Epi Info version 3.5.1 computer software and descriptive analysis was performed. Then, data were exported to SPSS version 16 computer software for statistical analysis.
RESULTS: Five infants were infected with HIV at the end of this study. The overall rate of vertical transmission of HIV was 6.2%. Maternal viral load at delivery was independently associated with both in utero and intra-partum transmission; (OR=27.0, (95%CI, 3.5-210, p=0.001). In addition maternal viral load at 6 weeks of birth and low infants’ birth weight were strongly associated with intra-partum transmission among breastfeeding mothers, OR=25.5, (95%CI, 1.14-572, p=0.04, OR=29.6, 95%CI, 3.2-273, p=0.004); respectively. There were 40% MTCT of HIV among non ARV drug users and only 3.9% among those used ARV drugs during their current pregnancy.
Conclusion: strategies planned to reduce maternal viral load during pregnancy can be successful in substantially reducing vertical transmission of HIV. In addition, other contributing factors for MTCT of HIV-1 should be controlled.
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Maternal viral load, mother to child transmission of HIV-1, ARV, and Ethiopia.