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Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India

BACKGROUND & OBJECTIVES: Mother-to-child transmission (MTCT) is the most significant route of HIV transmission in children below the age of 15 yr. In India, perinatal HIV transmission, even after treatment, accounts for 5.4 per cent of HIV cases. The present study was conducted to evaluate the e...

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Autores principales: Ahir, Swati P., Chavan, V., Kerkar, S., Samant-Mavani, P., Nanavati, R., Mehta, P.R., Mania-Pramanik, J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788205/
https://www.ncbi.nlm.nih.gov/pubmed/24056596
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author Ahir, Swati P.
Chavan, V.
Kerkar, S.
Samant-Mavani, P.
Nanavati, R.
Mehta, P.R.
Mania-Pramanik, J.
author_facet Ahir, Swati P.
Chavan, V.
Kerkar, S.
Samant-Mavani, P.
Nanavati, R.
Mehta, P.R.
Mania-Pramanik, J.
author_sort Ahir, Swati P.
collection PubMed
description BACKGROUND & OBJECTIVES: Mother-to-child transmission (MTCT) is the most significant route of HIV transmission in children below the age of 15 yr. In India, perinatal HIV transmission, even after treatment, accounts for 5.4 per cent of HIV cases. The present study was conducted to evaluate the efficacy of anti-retro viral therapy (ART) or prophylactic treatment (PT) to control maternal viral load in HIV positive women, and its effect on vertical HIV transmission to their infants. METHODS: A total of 58 HIV positive women were enrolled at the time of delivery and their plasma samples were obtained within 24 h of delivery for estimation of viral load. Viral load analysis was completed in 38 women. Infants received single dose nevirapine within 2 h of birth and zidovudine for 6 wk. At the end of 18 month follow up, HIV positive or negative status was available in 28 infants. RESULTS: Results revealed undetectable levels of viral load in 58.3 per cent of women with ART compared to 30.7 per cent of women with PT. No women on ART had viral load more than 10,000 copies/ml, whereas seven (26.9%, P=0.07) women receiving PT had this viral load. Median CD4 count of women on PT (483 cells/μl) was high compared to the women on ART (289 cells/ μl). At the end of 18 months follow up, only two children were HIV positive, whose mothers were on PT. One had in utero transmission; infection detected within 48 h of delivery, while the other child was infected post partum as HIV was detected at six months follow up. INTERPRETATION & CONCLUSIONS: Women who received a single dose of nevirapine during delivery had higher levels of viral load than women on ART. Combination drug therapy for pregnant women is now a standard of care in most of the western countries; use of nevirapine monotherapy at the time of delivery in our settings is not effective in controlling viral load. This highlights initiation of ART in pregnant women to control their viral load and thus to inhibit mother to child HIV transmission.
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spelling pubmed-37882052013-10-04 Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India Ahir, Swati P. Chavan, V. Kerkar, S. Samant-Mavani, P. Nanavati, R. Mehta, P.R. Mania-Pramanik, J. Indian J Med Res Original Article BACKGROUND & OBJECTIVES: Mother-to-child transmission (MTCT) is the most significant route of HIV transmission in children below the age of 15 yr. In India, perinatal HIV transmission, even after treatment, accounts for 5.4 per cent of HIV cases. The present study was conducted to evaluate the efficacy of anti-retro viral therapy (ART) or prophylactic treatment (PT) to control maternal viral load in HIV positive women, and its effect on vertical HIV transmission to their infants. METHODS: A total of 58 HIV positive women were enrolled at the time of delivery and their plasma samples were obtained within 24 h of delivery for estimation of viral load. Viral load analysis was completed in 38 women. Infants received single dose nevirapine within 2 h of birth and zidovudine for 6 wk. At the end of 18 month follow up, HIV positive or negative status was available in 28 infants. RESULTS: Results revealed undetectable levels of viral load in 58.3 per cent of women with ART compared to 30.7 per cent of women with PT. No women on ART had viral load more than 10,000 copies/ml, whereas seven (26.9%, P=0.07) women receiving PT had this viral load. Median CD4 count of women on PT (483 cells/μl) was high compared to the women on ART (289 cells/ μl). At the end of 18 months follow up, only two children were HIV positive, whose mothers were on PT. One had in utero transmission; infection detected within 48 h of delivery, while the other child was infected post partum as HIV was detected at six months follow up. INTERPRETATION & CONCLUSIONS: Women who received a single dose of nevirapine during delivery had higher levels of viral load than women on ART. Combination drug therapy for pregnant women is now a standard of care in most of the western countries; use of nevirapine monotherapy at the time of delivery in our settings is not effective in controlling viral load. This highlights initiation of ART in pregnant women to control their viral load and thus to inhibit mother to child HIV transmission. Medknow Publications & Media Pvt Ltd 2013-08 /pmc/articles/PMC3788205/ /pubmed/24056596 Text en Copyright: © The Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ahir, Swati P.
Chavan, V.
Kerkar, S.
Samant-Mavani, P.
Nanavati, R.
Mehta, P.R.
Mania-Pramanik, J.
Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India
title Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India
title_full Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India
title_fullStr Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India
title_full_unstemmed Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India
title_short Antiretroviral treatment, viral load of mothers & perinatal HIV transmission in Mumbai, India
title_sort antiretroviral treatment, viral load of mothers & perinatal hiv transmission in mumbai, india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788205/
https://www.ncbi.nlm.nih.gov/pubmed/24056596
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