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PA-098
UPTAKE OF ANTIRETROVIRAL THERAPY AMONG HIV-INFECTED PREGNANT WOMEN AND ITS IMPACT ON HIV MOTHER-TO-CHILD TRANSMISSION IN MBEYA, TANZANIA
  1. Issa Sabi Masenza1,
  2. Otto Geisenberger2,
  3. Peter Agrea1,
  4. Leonard Maboko1,
  5. France Rwegoshora3,
  6. Hellen Mahiga1,
  7. Willyhelmina Olomi1,
  8. Michael Hoelscher2,
  9. Arne Kroidl2
  1. 1NIMR-MMRC, Tanzania
  2. 2DITM, Medical Center, LMU, Germany
  3. 3Southern Highlands Zonal Hospital, Tanzania

Abstract

Background Maternal viral load (VL) and immunological status are important risk factors for mother-to-child transmission of HIV. In line with WHO recommendations (Option B+), Tanzania introduced the initiation of life long antiretroviral therapy (ART) in pregnant women in 2013. We present the uptake of ART and its impact on mother-to-child transmission.

Methods Between July 2015 and June 2016 data were obtained from HIV-infected pregnant women participating in the ongoing BABY Study (ClinicalTrials.gov Identifier: NCT02545296), which evaluates point-of-care testing in HIV Early Infant Diagnosis (HEID). Women were enrolled at the time of delivery, and neonates were followed-up until 6 weeks post-partum. Maternal HIV-RNA was assessed at delivery; neonatal HIV diagnosis was performed using the Cepheid Xpert point-of-care test and confirmed by qualitative dry blood spot HIV-DNA (Roche COBAS TaqMan).

Results In total 415 HIV-infected pregnant women were enrolled (median age 29 years). Nearly all women had attended antenatal care (96.4%); in 245 (59%) HIV was first diagnosed during pregnancy, and in 63.8% ART was initiated within 1 week following diagnosis. At the time of delivery 368 (88.7%) women were on ART, HIV-RNA >1000 copies/mL were detected in 78 (18.9%) and a CD4 count <200 cells/µL in 63 (15.2%). The overall mother-to-child HIV transmission rate was 2.4% (10/415) and 7/10 neonates were HIV diagnosed at the time of birth correctly identified by point-of-care testing. HIV-RNA >1000 copies/ml irrespectively of ART and low CD4 count <200 cells/μL were associated with higher risk of neonatal HIV transmission.

Conclusions Despite the implementation of life-long ART in all pregnant women, reduction of HIV transmission from mother to child is still sub-optimal. High HIV-RNA as the main risk factor for HIV transmission irrespective of maternal ART points to the need for maternal VL screening during the antenatal period.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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