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Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe

We conducted a 24-month prospective follow-up study, at a primary health care clinic in Harare, Zimbabwe, to determine cumulative mother-to-child transmission of HIV-1 (MTCT) rate and the contributions of intrauterine (IU), intrapartum (IP), and postpartum (PP) to MTCT, as well as maternal and infan...

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Autores principales: Zijenah, Lynn Sodai, Bandason, Tsitsi, Bara, Wilbert, Chipiti, Maria Mary, Katzenstein, David Allan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057887/
https://www.ncbi.nlm.nih.gov/pubmed/35438521
http://dx.doi.org/10.1089/apc.2021.0217
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author Zijenah, Lynn Sodai
Bandason, Tsitsi
Bara, Wilbert
Chipiti, Maria Mary
Katzenstein, David Allan
author_facet Zijenah, Lynn Sodai
Bandason, Tsitsi
Bara, Wilbert
Chipiti, Maria Mary
Katzenstein, David Allan
author_sort Zijenah, Lynn Sodai
collection PubMed
description We conducted a 24-month prospective follow-up study, at a primary health care clinic in Harare, Zimbabwe, to determine cumulative mother-to-child transmission of HIV-1 (MTCT) rate and the contributions of intrauterine (IU), intrapartum (IP), and postpartum (PP) to MTCT, as well as maternal and infant mortality rates in the era of Option B(+) combination antiretroviral therapy (cART). Plasma for viral load (VL) quantitation was obtained from 475 mothers enrolled into the study. VL was quantified at enrolment and every 6 months thereafter up to 24 months using the Cepheid GeneXpert HIV-1 Quantitative test. Dried blood spots were collected from 453 infants at birth, 4–6 weeks, 3 months, and every 3 months thereafter up to 24 months. HIV-1 infant diagnosis was conducted using the Cepheid GeneXpert HIV-1 Qualitative test. Absolute, cumulative MTCT rates and mortality rate were calculated. Seven mothers (1.55%) transmitted HIV-1 infection to their infants by 24 months. Four infants (0.88%; 95% CI 0.26–2.33%), one infant (0.22%; 95% CI 0–1.4%), and two infants (0.44%; 95% CI 0.01–1.7%) were infected IU, IP, and PP, respectively. By 24 months, 88.94% of the mothers and 80% of the infants had undetectable VL. The maternal and infant mortality rates were 0.21% and 1.78%, respectively. In the first 24 months of life, IU transmission is the major route of MTCT. The cumulative MTCT rate of 1.55% and low maternal and infant mortality rates of 0.21% and 1.78%, respectively, contribute to growing evidence that Option B(+) cART not only drastically reduces MTCT but also maternal and infant mortality.
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spelling pubmed-90578872022-05-02 Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe Zijenah, Lynn Sodai Bandason, Tsitsi Bara, Wilbert Chipiti, Maria Mary Katzenstein, David Allan AIDS Patient Care STDS Clinical and Epidemiologic Research We conducted a 24-month prospective follow-up study, at a primary health care clinic in Harare, Zimbabwe, to determine cumulative mother-to-child transmission of HIV-1 (MTCT) rate and the contributions of intrauterine (IU), intrapartum (IP), and postpartum (PP) to MTCT, as well as maternal and infant mortality rates in the era of Option B(+) combination antiretroviral therapy (cART). Plasma for viral load (VL) quantitation was obtained from 475 mothers enrolled into the study. VL was quantified at enrolment and every 6 months thereafter up to 24 months using the Cepheid GeneXpert HIV-1 Quantitative test. Dried blood spots were collected from 453 infants at birth, 4–6 weeks, 3 months, and every 3 months thereafter up to 24 months. HIV-1 infant diagnosis was conducted using the Cepheid GeneXpert HIV-1 Qualitative test. Absolute, cumulative MTCT rates and mortality rate were calculated. Seven mothers (1.55%) transmitted HIV-1 infection to their infants by 24 months. Four infants (0.88%; 95% CI 0.26–2.33%), one infant (0.22%; 95% CI 0–1.4%), and two infants (0.44%; 95% CI 0.01–1.7%) were infected IU, IP, and PP, respectively. By 24 months, 88.94% of the mothers and 80% of the infants had undetectable VL. The maternal and infant mortality rates were 0.21% and 1.78%, respectively. In the first 24 months of life, IU transmission is the major route of MTCT. The cumulative MTCT rate of 1.55% and low maternal and infant mortality rates of 0.21% and 1.78%, respectively, contribute to growing evidence that Option B(+) cART not only drastically reduces MTCT but also maternal and infant mortality. Mary Ann Liebert, Inc., publishers 2022-04-01 2022-04-14 /pmc/articles/PMC9057887/ /pubmed/35438521 http://dx.doi.org/10.1089/apc.2021.0217 Text en © Lynn Sodai Zijenah, et al., 2022; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by-nc/4.0/This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Clinical and Epidemiologic Research
Zijenah, Lynn Sodai
Bandason, Tsitsi
Bara, Wilbert
Chipiti, Maria Mary
Katzenstein, David Allan
Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe
title Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe
title_full Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe
title_fullStr Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe
title_full_unstemmed Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe
title_short Impact of Option B(+) Combination Antiretroviral Therapy on Mother-to-Child Transmission of HIV-1, Maternal and Infant Virologic Responses to Combination Antiretroviral Therapy, and Maternal and Infant Mortality Rates: A 24-Month Prospective Follow-Up Study at a Primary Health Care Clinic, in Harare, Zimbabwe
title_sort impact of option b(+) combination antiretroviral therapy on mother-to-child transmission of hiv-1, maternal and infant virologic responses to combination antiretroviral therapy, and maternal and infant mortality rates: a 24-month prospective follow-up study at a primary health care clinic, in harare, zimbabwe
topic Clinical and Epidemiologic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057887/
https://www.ncbi.nlm.nih.gov/pubmed/35438521
http://dx.doi.org/10.1089/apc.2021.0217
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