Human Immunodeficiency Virus Infection among Exposed Infants in Selected Primary Health-Care Facilities in Nigeria: A Retrospective Cohort Study

Abstract

BACKGROUND: Nigeria is the second largest country with paediatric HIV infections. Mother to Child transmission of HIV remains a major source of paediatric infection in Nigeria. This study was conducted to determine the outcomes of HIV exposed infants in selected Primary Health Care Centres.
METHODS: A retrospective cohort study on HIV exposed infants between January 2015 to July 2016. A proforma was used to abstract information from clinic records on socio-demographics characteristics, ARV prophylaxis, mode of delivery, birth weight, infant prophylaxis, early infant diagnosis (EID), referral to ART. Descriptive and multivariate analysis was done to determine predictors of HIV infection among exposed infants.
RESULTS: 170 exposed infants were recruited, and more than two-third of the infants were males (74.1%) with median age 4±3months ranging from (0 -11months). One hundred and fifty (88.2%) received infant prophylaxis and 116 (68.2%) had EID done at 6weeks. Of the 170 exposed infants 19(11.1%) were positive at 18months. Predictors of HIV infection were age of mothers ≥30years (Adjusted Odd’s Ratio = 2.5,95%CI 1.9 – 16.93), Vaginal tear (Adjusted OR= 2.7,95%CI 2.1- 19.21), infants whose maternal CD4 count < 500(Adjusted OR= 3.5,95%CI 1.7 -15.02) and infant received prophylaxis other than daily Nevirapine for 6weeks (Adjusted OR=3.0,95%CI 2.4-12.74).
CONCLUSION: The positivity rate among studied exposed infants was high. Continuous placement of younger HIV positive mothers and exposed infants on recommended prophylaxis and timely early infant diagnosis will go a long way in reducing the burden of paediatric HIV.