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Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis

INTRODUCTION: The Chinese government has invested US$140 million annually on prevention of mother-to-child transmission (PMTCT) of HIV. This study evaluates the programme by examining the improvements in programme coverage HIV testing and provision of antiviral drugs along the PMTCT cascade. METHODS...

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Autores principales: Zeng, Huan, Chow, Eric P F, Zhao, Yong, Wang, Yang, Tang, Maozhi, Li, Leyu, Tang, Xue, Liu, Xi, Zhong, Yi, Wang, Ailing, Lo, Ying-Ru, Zhang, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783331/
https://www.ncbi.nlm.nih.gov/pubmed/25935929
http://dx.doi.org/10.1136/sextrans-2014-051877
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author Zeng, Huan
Chow, Eric P F
Zhao, Yong
Wang, Yang
Tang, Maozhi
Li, Leyu
Tang, Xue
Liu, Xi
Zhong, Yi
Wang, Ailing
Lo, Ying-Ru
Zhang, Lei
author_facet Zeng, Huan
Chow, Eric P F
Zhao, Yong
Wang, Yang
Tang, Maozhi
Li, Leyu
Tang, Xue
Liu, Xi
Zhong, Yi
Wang, Ailing
Lo, Ying-Ru
Zhang, Lei
author_sort Zeng, Huan
collection PubMed
description INTRODUCTION: The Chinese government has invested US$140 million annually on prevention of mother-to-child transmission (PMTCT) of HIV. This study evaluates the programme by examining the improvements in programme coverage HIV testing and provision of antiviral drugs along the PMTCT cascade. METHODS: Data for PMTCT cascade indicators were collected through a comprehensive systematic review of published peer-reviewed English and Chinese literature during 2003–2011. Meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: This study included 113 publications. HIV prevalence among pregnant women in China who accessed antenatal care (ANC) remained below 0.1% during the past decade. HIV testing coverage in pregnant women attending ANC and in HIV-exposed infants at 18 months significantly increased from 62.4% (95% CI 4.7% to 98.2%) and 22.1% (16.3% to 32.3%) in 2003 to 90.3% (88.4% to 91.8%) and 82.8% (66.9% to 99.5%) in 2011 respectively, whereas antiretroviral (ARV) prophylaxis uptake increased from 35.2% (12.2% to 47.3%) and 26.9% (24.3% to 28.9%) to 86.2% (53.2% to 97.2%) and 90.3% (85.5% to 93.7%). HIV vertical transmission rate substantially decreased from 31.8% (25.7% to 38.6%) prior to the programme to 2.3% (1.4% to 3.8%) in 2011. During 2003–2011, among 25 312 (23 995–26 644) infants born to HIV-positive mothers who received ARV prophylaxis, 975 (564–1395) were diagnosed with HIV, corresponding to an average transmission rate of 3.9% (3.2% to 4.6%). However, while including transmissions among HIV-positive pregnant women who were lost along the cascade, the average transmission rate during 2003–2011 was 17.4% (15.8% to 19.0%). CONCLUSIONS: PMTCT programmes have reduced HIV mother-to-child transmission in China. Further improvements in the continuum of care remain essential in realising the full potential of the programme.
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spelling pubmed-47833312016-03-10 Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis Zeng, Huan Chow, Eric P F Zhao, Yong Wang, Yang Tang, Maozhi Li, Leyu Tang, Xue Liu, Xi Zhong, Yi Wang, Ailing Lo, Ying-Ru Zhang, Lei Sex Transm Infect Clinical INTRODUCTION: The Chinese government has invested US$140 million annually on prevention of mother-to-child transmission (PMTCT) of HIV. This study evaluates the programme by examining the improvements in programme coverage HIV testing and provision of antiviral drugs along the PMTCT cascade. METHODS: Data for PMTCT cascade indicators were collected through a comprehensive systematic review of published peer-reviewed English and Chinese literature during 2003–2011. Meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: This study included 113 publications. HIV prevalence among pregnant women in China who accessed antenatal care (ANC) remained below 0.1% during the past decade. HIV testing coverage in pregnant women attending ANC and in HIV-exposed infants at 18 months significantly increased from 62.4% (95% CI 4.7% to 98.2%) and 22.1% (16.3% to 32.3%) in 2003 to 90.3% (88.4% to 91.8%) and 82.8% (66.9% to 99.5%) in 2011 respectively, whereas antiretroviral (ARV) prophylaxis uptake increased from 35.2% (12.2% to 47.3%) and 26.9% (24.3% to 28.9%) to 86.2% (53.2% to 97.2%) and 90.3% (85.5% to 93.7%). HIV vertical transmission rate substantially decreased from 31.8% (25.7% to 38.6%) prior to the programme to 2.3% (1.4% to 3.8%) in 2011. During 2003–2011, among 25 312 (23 995–26 644) infants born to HIV-positive mothers who received ARV prophylaxis, 975 (564–1395) were diagnosed with HIV, corresponding to an average transmission rate of 3.9% (3.2% to 4.6%). However, while including transmissions among HIV-positive pregnant women who were lost along the cascade, the average transmission rate during 2003–2011 was 17.4% (15.8% to 19.0%). CONCLUSIONS: PMTCT programmes have reduced HIV mother-to-child transmission in China. Further improvements in the continuum of care remain essential in realising the full potential of the programme. BMJ Publishing Group 2016-03 2015-05-02 /pmc/articles/PMC4783331/ /pubmed/25935929 http://dx.doi.org/10.1136/sextrans-2014-051877 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 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/
spellingShingle Clinical
Zeng, Huan
Chow, Eric P F
Zhao, Yong
Wang, Yang
Tang, Maozhi
Li, Leyu
Tang, Xue
Liu, Xi
Zhong, Yi
Wang, Ailing
Lo, Ying-Ru
Zhang, Lei
Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis
title Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis
title_full Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis
title_fullStr Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis
title_full_unstemmed Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis
title_short Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis
title_sort prevention of mother-to-child hiv transmission cascade in china: a systematic review and meta-analysis
topic Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783331/
https://www.ncbi.nlm.nih.gov/pubmed/25935929
http://dx.doi.org/10.1136/sextrans-2014-051877
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