Prevalence of Mother-to-Child Transmission of Human Immunodeficiency Virus in Pregnant Women on Antiretroviral Prophylaxis At Kenyatta National Hospital, Nairobi County
Karegi, Jane Francis
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Mother to child HIV transmission (MTCT) accounts for the majority of the paediatrics HIV-1 infections. Long and short term treatment of HIV-positive pregnant mother with ARV regimen has been reported to reduce MTCT rate by 70%. However, the current effect of ARVs on CD4 count and prevalence of MTCT of HIV needs to be established in an effort to completely eradicate MTCT of HIV. This study investigated the effects of triple ARV regimen on the CD4 count of HIV-positive pregnant mothers and the outcome of HIV-status of their infants at Kenyatta National Hospital, in Nairobi County. One hundred seventeen 117 HIV-1 infected pregnant mothers were enrolled in the study. A single-arm study design was used. Social demographic characteristics and knowledge of HIV, ARV and MTCT of HIV data was collected using structured questionnaires. Baseline CD4 count was determined at enrolment. HIV-1 infected pregnant mothers were treated with triple ARV regimen (3CT, d4T and NVP) from the range of 5-7 months gestation age to six weeks after delivery. CD4 count and viral load were determined at delivery (36 wks gestation). Infants were treated with a single dose of Nevirapine from birth to six weeks after delivery. Infant’s blood sample was collected at six week and PCR test done to determine their HIV-status. Results showed a highly significant statistical relationship between ARVs and CD4 cell count at delivery (t = 9.82; df=111; p < 0.0001) whereby increase in CD4 count from baseline to delivery were recorded in all age categories of the respondents, apart from those above 43 years old. Out 114 mothers who participated to the end of the study, only three mothers transmitted the HIV virus to their infants. Mean baseline CD4 count and mean CD4 count at delivery of mothers who infected their infants were, 80cells/ml of blood and 89cells/ml of blood respectively, thus very low, while the mean baseline CD4 count and mean CD4 count at delivery of mothers who did not transmit the HIV virus were 408 cells /ml of blood and 505 cells / ml of blood respectively. The mean viral load at delivery of mothers who transmitted the HIV virus to their infants was 407447 copies/ml of blood, while the mean viral load at delivery of mothers who did not transmit the HIV virus to their infants was 1578 copies/ml of blood. The estimated proportion of HIV-1 infected infants was 2.6% at 6 weeks after delivery. The results indicates that the level of knowledge among HIV positive pregnant women on HIV, ARVs and MTCT of HIV was good (> 80%) and there was a highly statistical relationship between knowledge and level of education of the respondents (x2=39; df=3; p<0.0001). Anti-retroviral drugs should be made more accessible and affordable to HIV- positive pregnant women as they are highly effective in controlling MTCT of HIV-1.
- MST-Zoological Sciences