A Descriptive Study of Outcomes of Interventions to Prevent Mother to Child Transmission of HIV in Lusaka, Zambia

Abstract

Objective: To determine the effectiveness of the Prevention of Mother-To-Child Treatment (PMTCT) interventions, in reducing mother-to-child transmission of Human Immune Deficiency Virus (HIV) infection in infants born to HIV infected women in two health centers Lusaka district (MTCT-Plus cohort) between 2002 and 2007.

Design: A retrospective observational cohort study.

Main outcome measure: Transmission of HIV infection from mother to child, defined as proportion of infants born to HIV infected women that had taken prevention of mother-to-child interventions, who became HIV
infected.

Results: A total of 534 infants had their final HIV status established, of which 101 (18.9%) were positive. A total of 372(67.7%) of 534 mother-infant pairs took single dose nevirapine, whilst 91 (17%) took triple therapy. The proportion of infants with a positive HIV test was much
lower in infants where the maternal regimen was Highly Active Antiretroviral Therapy (HAART) at 6.6% (6/91), whilst that of infants where the maternal regimen was single dose nevirapine was 19.9% (74/372), (Chi-square
test p-value 0.0005). Mixed feeding for six months was significantly associated with a positive infant HIV outcome (AOR 1.86[1.02-3.41], p-value 0.044).

Conclusion: This study indicates that the Prevention of Mother-to- Child Transmission of HIV treatment interventions in reducing transmission of HIV in infants and young children in two Lusaka urban clinics had been
effective. Exclusive breastfeeding for 6 months, and use of triple therapy can reduce the transmission of HIV significantly.