Devenir sérologique et nutritionnel des nourrissons nés de mères séropositives suivis dans l’option B+ à Guédiawaye

As part of its Plan to eliminate mother-to-child transmission of HIV, Senegal has adopted, since 2012, WHO's B + option, which consists of systematic triple therapy for HIV-positive pregnant women associated with breastfeeding and antiretroviral (ARV) prophylaxis for their infants. Our study aims to analyze the risks of mother-to-child transmission of HIV and the nutritional outcome of infants undergoing B + option. Material and methods: We conducted a descriptive, retrospective study at the King Baudouin health center in Guédiaway from 1 September 2012 to 30 April 2015. All infants whose mothers were on triple therapy, undergoing protected breastfeeding, ARV prophylaxis and serological test at 14th months were included in the study. The parameters studied were mother's age and serological profile, father's serological status, the sharing of the status within the couple, infant nourishing, infant ARV prophylaxis, nutritional status at 6 and 12 months and serological status of the infant at 14 months. Out of the 126 infants undergoing PMTCT program, 42 or 33.33% of infants following the B + guidelines were included in the study. The age of mothers ranged from 15 to 42 years, with an average age of 31 years. The majority of mothers (88.1%) carried type 1 virus and 11.9% carried type 2 virus; 20 couples (47.62%) were sero-concordant, 14 were serodifferent, while the serological status was unknown or not investigated in 8 fathers (19.05%). A significant difference between fathers' serological profile and the sharing status (p <0.05) was found. The majority of infants (88.1%) were born at term via vaginal delivery (95.2%), with an average birth weight of 2880 grams. In relation to prophylaxis, the majority of infants received prophylactic monotherapy, 27 (64.28%) received NVP, 4 (9.52%) received AZT, while 11 (26.19%) received triple combination of AZT + 3TC + NVP. The AME was effective in 80.9% of infants and weaning began at 12 months in 80.9% of infants. In relation to nutritional status, at 6 months 12% and 7.1% of infants had MAM and MAS respectively. At 12 months, 19.1% of infants had MAM. Retroviral serology was negative in all the 42 infants at 14 months. B + option is an effective strategy to reduce the MTCT rate. However, early malnutrition in children requires nutritional support for breastfeeding mothers as well as a good psychosocial support.