Mother-to-child transmission of HIV: findings from an Early Infant Diagnosis program in Bertoua, Eastern Cameroon

Abstract

Introduction: Early diagnosis of HIV is crucial to ensure early antiretroviral (ARV) treatment which is associated with lower mortality in HIVinfected children. This study reports the prevalence of HIV infection and the factors associated to mother-to-child transmission (MTCT) in an Early Infant Diagnosis (EID) program in Bertoua, Cameroon.

Methods: We reviewed the records of 112 HIV-exposed infants aged six weeks to 18 months who had an HIV-1 DNA PCR test done in 2010. Data included socio-demographic characteristics, clinical manifestations of HIV, ARV prophylaxis, feeding options and results of the PCR tests.

Results: The median age at first HIV testing was 4 months (IQR, 2-7). Ninety-one point one percent of infants and 65.2% of mothers did not receive ARV prophylaxis. Fifty infants (44.6%) were exclusively breastfed, 37 (33%) received formula feeding and 25 (22.4%) received mixed feeding. The prevalence of HIV in the infants was 11.6%. MTCT of HIV was significantly associated with mixed feeding (adjusted odds ratio (aOR): 6.7, 95% CI 1.6-28.3; p=0.009) and an age at 1st PCR test greater than 6 months (aOR: 6.5, 95% CI 1.4-29.3; p=0.014). The mothers of 66.1% of the infants tested returned to collect the result.

Conclusion: There is a high rate of MTCT of HIV in this setting, due to a poor implementation of the PMTCT program. There is a critical need to increase the use of ARV prophylaxis, and to improve rapid first testing and completion of the EID. The infant feeding practices also have to be improved.

Key words: Mother-to-child transmission of HIV, early infant diagnosis, polymerase chain reaction, Cameroon