Early Diagnosis of HIV-1 in Infants: The Prevention of Mother-To-Child Transmission Program in Equatorial Guinea
BACKGROUND:
Great
efforts have been made in the last few years in order to implement the
prevention of mother-to-child transmission (PMTCT) program in Equatorial Guinea
(GQ). The aim of this study was to evaluate the rates of mother-to-child HIV
transmission based on an HIV early infant diagnosis (EID) program.
METHODS:
A
prospective observational study was performed in the Regional Hospital of Bata
and Primary Health Care Centre Maria Rafols, Bata, GQ. Epidemiological,
clinical, and microbiological characteristics of HIV-1-infected mothers and
their exposed infants were recorded. Dried blood spots (DBS) for HIV-1 EID were
collected from November 2012 to December 2013. HIV-1 genome was detected using
Siemens VERSANT HIV-1 RNA 1.0 kPCR assay.
RESULTS:
Sixty
nine pairs of women and infants were included. Sixty women (88.2%) had WHO
clinical stage 1. Forty seven women (69.2%) were on antiretroviral treatment during
pregnancy. Forty five infants (66.1%) received postnatal antiretroviral
prophylaxis. Age at first DBS analysis was 2.4 months (IQR 1.2-4.9). One infant
died before a HIV-1 diagnosis could be ruled out. Two infants were HIV-1
infected and started HAART before any symptoms were observed. The rate of HIV-1
transmission observed was 2.9% (95%CI 0.2-10.5).
CONCLUSIONS:
The
PMTCT rate was evaluated for the first time in GQ based on EID. EID is the key
for early initiation of antiretroviral therapy and to reduce the mortality
associated with HIV infection.
By: Prieto-Tato LM1, Vargas A2, Álvarez P3, Avedillo P4, Nzi E5, Abad C4, Guillén S6, Fernández-McPhee C3, Ramos JT7, Holguín Á3, Rojo P4, Obiang J8.
- 1Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España. Electronic address: lmprieto.hugf@salud.madrid.org.
- 2Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, RICET, Madrid, España.
- 3Laboratorio de Epidemiología Molecular VIH-1, Departamento de Microbiología y Parasitología, Hospital Universitario Ramón y Cajal, IRYCIS y CIBERESP, Madrid, España.
- 4Departamento de Enfermedades Infecciosas e Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España.
- 5Servicio de Análisis Clínicos, Hospital Regional de Bata Dr. Damian Roku, Bata, Guinea Ecuatorial.
- 6Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España.
- 7Servicio de Pediatría, Hospital Universitario Clínico San Carlos, Madrid, España.
- 8Servicio de Pediatría, Hospital Regional de Bata Dr. Damian Roku, Bata, Guinea Ecuatorial.
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