Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis.
<h4>Background</h4>Mother to child transmission (MTCT) of HIV-1 remains an important problem in sub-Saharan Africa where most new pediatric HIV-1 infections occur. Early infant diagnosis of HIV-1 using dried blood spot (DBS) PCR among exposed infants provides an opportunity to assess cur...
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2014
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oai:doaj.org-article:6ee3804b94e14b41a0a02c366adce8592021-11-18T08:32:37ZProgress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis.1932-620310.1371/journal.pone.0088679https://doaj.org/article/6ee3804b94e14b41a0a02c366adce8592014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24551134/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Mother to child transmission (MTCT) of HIV-1 remains an important problem in sub-Saharan Africa where most new pediatric HIV-1 infections occur. Early infant diagnosis of HIV-1 using dried blood spot (DBS) PCR among exposed infants provides an opportunity to assess current MTCT rates.<h4>Methods</h4>We conducted a retrospective data analysis on mother-infant pairs from all PMTCT programs in three regions of northern Tanzania to determine MTCT rates from 2008-2010. Records of 3,016 mother-infant pairs were assessed to determine early transmission among HIV-exposed infants in the first 75 days of life.<h4>Results</h4>Of 2,266 evaluable infants in our cohort, 143 had a positive DBS PCR result at ≤ 75 days of life, for an overall transmission rate of 6.3%. Transmission decreased substantially over the period of study as more effective regimens became available. Transmission rates were tightly correlated to maternal regimen: 14.9% (9.5, 20.3) of infants became infected when women received no therapy; 8.8% (6.9, 10.7) and 3.6% (2.4, 4.8) became infected when women received single-dose nevirapine (sdNVP) or combination prophylaxis, respectively; the lowest MTCT rates occurred when women were on HAART, with 2.1% transmission (0.3, 3.9). Treatment regimens changed dramatically over the study period, with an increase in combination prophylaxis and a decrease in the use of sdNVP. Uptake of DBS PCR more than tripled over the period of study for the three regions surveyed.<h4>Conclusions</h4>Our study demonstrates significant reductions in MTCT of HIV-1 in three regions of Tanzania coincident with increased use of more effective PMTCT interventions. The changes we demonstrate for the period of 2008-2010 occurred prior to major changes in WHO PMTCT guidelines.Ann M BuchananDorothy E DowCharles G MassambuBalthazar NyombiAisa ShayoRahma MusokeSheng FengJohn A BartlettColeen K CunninghamWerner SchimanaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e88679 (2014) |
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Medicine R Science Q Ann M Buchanan Dorothy E Dow Charles G Massambu Balthazar Nyombi Aisa Shayo Rahma Musoke Sheng Feng John A Bartlett Coleen K Cunningham Werner Schimana Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis. |
| description |
<h4>Background</h4>Mother to child transmission (MTCT) of HIV-1 remains an important problem in sub-Saharan Africa where most new pediatric HIV-1 infections occur. Early infant diagnosis of HIV-1 using dried blood spot (DBS) PCR among exposed infants provides an opportunity to assess current MTCT rates.<h4>Methods</h4>We conducted a retrospective data analysis on mother-infant pairs from all PMTCT programs in three regions of northern Tanzania to determine MTCT rates from 2008-2010. Records of 3,016 mother-infant pairs were assessed to determine early transmission among HIV-exposed infants in the first 75 days of life.<h4>Results</h4>Of 2,266 evaluable infants in our cohort, 143 had a positive DBS PCR result at ≤ 75 days of life, for an overall transmission rate of 6.3%. Transmission decreased substantially over the period of study as more effective regimens became available. Transmission rates were tightly correlated to maternal regimen: 14.9% (9.5, 20.3) of infants became infected when women received no therapy; 8.8% (6.9, 10.7) and 3.6% (2.4, 4.8) became infected when women received single-dose nevirapine (sdNVP) or combination prophylaxis, respectively; the lowest MTCT rates occurred when women were on HAART, with 2.1% transmission (0.3, 3.9). Treatment regimens changed dramatically over the study period, with an increase in combination prophylaxis and a decrease in the use of sdNVP. Uptake of DBS PCR more than tripled over the period of study for the three regions surveyed.<h4>Conclusions</h4>Our study demonstrates significant reductions in MTCT of HIV-1 in three regions of Tanzania coincident with increased use of more effective PMTCT interventions. The changes we demonstrate for the period of 2008-2010 occurred prior to major changes in WHO PMTCT guidelines. |
| format |
article |
| author |
Ann M Buchanan Dorothy E Dow Charles G Massambu Balthazar Nyombi Aisa Shayo Rahma Musoke Sheng Feng John A Bartlett Coleen K Cunningham Werner Schimana |
| author_facet |
Ann M Buchanan Dorothy E Dow Charles G Massambu Balthazar Nyombi Aisa Shayo Rahma Musoke Sheng Feng John A Bartlett Coleen K Cunningham Werner Schimana |
| author_sort |
Ann M Buchanan |
| title |
Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis. |
| title_short |
Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis. |
| title_full |
Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis. |
| title_fullStr |
Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis. |
| title_full_unstemmed |
Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis. |
| title_sort |
progress in the prevention of mother to child transmission of hiv in three regions of tanzania: a retrospective analysis. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/6ee3804b94e14b41a0a02c366adce859 |
| work_keys_str_mv |
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