Prevention-of-Mother-To-Child Programmes for the preclusion of vertical transmission of human immuno-deficiency virus: A systematic review

Abstract

The National Strategic Plan (NSP) 2012-2016 advocates zero new HIV infections due to vertical transmission, but this goal is far from being achieved. This study undertook a systematic review of Randomised Controlled Trials (RCT) that compared Prevention of Mother-To-Child- Transmission (PMTCT) antiretroviral (ARV) regimes, published between 2000 to 2015 that evaluated the efficiency of ARVs. Overall, 25 randomised controlled trials that assessed efficacy of ARV regimens to prevent mother-to-child transmission of the HIV during pregnancy, labour and postnatal periods were meta-analysed. The systematic review indicated that significantly fewer infants tested HIV-positive when exposed to a longer ARV regime although there was no significant difference once the infants reached six months of age. Different ARVs had similar effects on maternal deaths; however, a double or triple combination of ARVs is superior to monotherapy in decreasing infant deaths. Common maternal adverse reactions to ARVs included anaemia, bronchopneumonia, and maculopapular rash. Infant adverse events included septicaemia, pneumonia, gastroenteritis, fever and maculopapular rash. Adverse events always pose a challenge and as with any other medication, caregivers must be aware of potential adverse reactions and whether the possible benefits of ARV’s outweigh the potential adverse events that may occur.

Keywords: Human Immuno-deficiency virus, mother-to-child-transmission, antiretroviral treatment, pregnant women, infant