The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 4
Risks associated with mother-to-child transmission of HIV infection
Félicitée Nguefack 1-2 ,Paul Koki Ndombo 1-3 ,Rose Ngoh 3 ,Florence Soh Fru 2 ,Mina Ntoto Kinkela 3 ,Andreas Chiabi 1-2
1 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
2 Yaounde Gynaeco-Obstetric and Pediatric Hospital
3 Mother and Child Center of the Chantal Biya Foundation
DOI : 10.24953/turkjped.2017.04.009 Nguefack F, Koki-Ndombo P, Ngoh R, Soh Fru F, Kinkela MN, Chiabi A. Risks associated with mother-to-child transmission of HIV infection. Turk J Pediatr 2017; 59: 426-433.

Early infant diagnosis (EID) permits the detection of Human Immunodeficiency Virus (HIV) infection in exposed children from 4-6 weeks by polymerase chain reaction (PCR). The aim of this study was to assess some maternal and infant characteristics associated with HIV infected children in an EID program.

A retrospective study was performed using records of HIV exposed children enrolled in the EID program from 2009 to 2013. Patients recruited were from various health structures and at different clinical stages; some for the Prevention of Mother-to-Child Transmission (PMTCT) follow up, others with signs of HIV infection. Data was collected from completed hospital records of children aged 6 weeks to 18 months containing at least two PCR, one PCR and one serologic test, or one PCR test and viral load. HIV infection was considered if one of the of tests was positive.

In all, 130 (5.3%) exposed children with only one positive PCR test, and 1,442 (59%) others with information lacking in their record were excluded. A total 107 out of 871 infants enrolled (12.2%) were infected. Only, 32.7% of the mothers were on antiretroviral therapy (ART). Of these, 53.3% had their first PCR performed between 6 weeks and 6 months. Children were less likely to be HIV infected when their mothers received antiretroviral (ARV) (OR=0.15, 95% CI 0.07-0.30, P=0.000). Factors associated with HIV infection in the children were the lack of ARV prophylaxis (OR=2.07, 95%CI 1.05-4.09, P=0.035) and having mixed feeding (OR=3.91, 95% CI 1.66-9.24, P=0.002) in multivariate analysis.

The high rate of infection associated with the maternal and infant correlates of HIV infected children would result from the poor implementation of the PMTCT. Systematic screening of pregnant and breastfeeding women should be reinforced and the lifelong ARVs for PMTCT (Option B+) be promoted. Keywords : HIV, early infant diagnosis, infection, factors

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