Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda
Since 2012, the WHO recommends lifelong ART with TDF+FTC/3TC+EFV for all HIV-positive pregnant and breastfeeding women (Option B-plus). In this analysis we describe the proportion of early and late transmission in mothers with high retention in Kampala, Uganda. We included 700 pregnant women from Ja...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2017/3202737 |
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| author | Barbara Castelnuovo Frank Mubiru Ivan Kalule Shadia Nakalema Agnes Kiragga |
| author_facet | Barbara Castelnuovo Frank Mubiru Ivan Kalule Shadia Nakalema Agnes Kiragga |
| author_sort | Barbara Castelnuovo |
| collection | DOAJ |
| description | Since 2012, the WHO recommends lifelong ART with TDF+FTC/3TC+EFV for all HIV-positive pregnant and breastfeeding women (Option B-plus). In this analysis we describe the proportion of early and late transmission in mothers with high retention in Kampala, Uganda. We included 700 pregnant women from January 2012 to August 2014 with a follow-up extended to August 2016; the median age was 31 years (IQR: 26–35), 36.3% in WHO stage 3/4; median CD4 count was 447 cells/μL (IQR: 301–651) and 73.3% were already on ART for a median time of 28 (IQR: 10–57) months; 52% infants were male and median weight was 3.2 Kg (IQR: 2.5–3.5). Five hundred and sixty-five (80.7%) infants had at least one test for HIV; 22 (3.1%) infants died, all with unknown serostatus; 3 tested positive at week 6 and one additional at months 12 and 18. Two of the mothers of the 4 HIV-positive infants were ART-naïve at the time of pregnancy. We report very low documented HIV transmission comparable with those reported in clinical trials settings; however, demonstrating the efficacy of Option B-plus in terms of averted transmission in routine settings is challenging since high proportion of infants do not have documented HIV tests. |
| format | Article |
| id | doaj-art-2a257397183441f299eab8eaecd05b60 |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
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| series | AIDS Research and Treatment |
| spelling | doaj-art-2a257397183441f299eab8eaecd05b602025-02-03T01:07:44ZengWileyAIDS Research and Treatment2090-12402090-12592017-01-01201710.1155/2017/32027373202737Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in UgandaBarbara Castelnuovo0Frank Mubiru1Ivan Kalule2Shadia Nakalema3Agnes Kiragga4Infectious Diseases Institute, Makerere University, Kampala, UgandaInfectious Diseases Institute, Makerere University, Kampala, UgandaInfectious Diseases Institute, Makerere University, Kampala, UgandaInfectious Diseases Institute, Makerere University, Kampala, UgandaInfectious Diseases Institute, Makerere University, Kampala, UgandaSince 2012, the WHO recommends lifelong ART with TDF+FTC/3TC+EFV for all HIV-positive pregnant and breastfeeding women (Option B-plus). In this analysis we describe the proportion of early and late transmission in mothers with high retention in Kampala, Uganda. We included 700 pregnant women from January 2012 to August 2014 with a follow-up extended to August 2016; the median age was 31 years (IQR: 26–35), 36.3% in WHO stage 3/4; median CD4 count was 447 cells/μL (IQR: 301–651) and 73.3% were already on ART for a median time of 28 (IQR: 10–57) months; 52% infants were male and median weight was 3.2 Kg (IQR: 2.5–3.5). Five hundred and sixty-five (80.7%) infants had at least one test for HIV; 22 (3.1%) infants died, all with unknown serostatus; 3 tested positive at week 6 and one additional at months 12 and 18. Two of the mothers of the 4 HIV-positive infants were ART-naïve at the time of pregnancy. We report very low documented HIV transmission comparable with those reported in clinical trials settings; however, demonstrating the efficacy of Option B-plus in terms of averted transmission in routine settings is challenging since high proportion of infants do not have documented HIV tests.http://dx.doi.org/10.1155/2017/3202737 |
| spellingShingle | Barbara Castelnuovo Frank Mubiru Ivan Kalule Shadia Nakalema Agnes Kiragga Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda AIDS Research and Treatment |
| title | Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda |
| title_full | Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda |
| title_fullStr | Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda |
| title_full_unstemmed | Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda |
| title_short | Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda |
| title_sort | challenges in assessing outcomes among infants of pregnant hiv positive women receiving art in uganda |
| url | http://dx.doi.org/10.1155/2017/3202737 |
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