Study on impact of maternal CD4 count on birth outcomes and mother to child transmission of HIV infection
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20162550Keywords:
Breastfeeding, HIV, Low birth weight, Perinatal transmission, PrematurityAbstract
Background: To study the effect of antenatal maternal CD4 count on prematurity, low birth weight and vertical transmission among HIV positive pregnant women in settings with increased uptake of exclusive breastfeeding as infant feeding option.
Methods: Design of the study was prospective study. 3 hospitals attached to EGPAF PPTCT Centre at Bapuji Child Health Institute, JJM Medical College, Davangere. 50 Mother-baby pairs attending PPTCT centre. Main outcome measures: prematurity, low birth weight, infant feeding option and vertical transmission of HIV in relation to maternal CD4 count.
Results: Prematurity rates were 13.6% (3/22) and (3/28) mothers with CD4 cell count below and above 350 cells/mm3 respectively. Low birth weight rates were 36.3% (8/22) and 35.7% (10/28) mothers with CD4 cell count below and above 350 cells/mm3 respectively. Vertical transmission of HIV was 3.6 % (1/28) and 4.5% (1/22) among mothers with CD4 count above and below 350cells/mm3 respectively. There was no statistically significant association between low maternal CD4 count and adverse birth outcomes and also vertical transmission of HIV. Mothers opting for exclusive breastfeeding were 100% (22/22) and 82.1% (23/28) with CD4 cell count below and above 350 cells/mm3 respectively (p 0.04). At the same time, rates of vertical transmission did not vary between the two groups of mothers (p 0.86).
Conclusions: Low maternal CD4 count did not affect birth outcomes and vertical transmission of HIV. Mother-to-child transmission of HIV remained below <5% while significantly increasing number of mothers took up breastfeeding as infant feeding option.Metrics
References
Global report: UNAIDS report on the global AIDS epidemic 2013.
Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach. 2010 version. WHO.
Bulletin of the World Health Organization. Breast is always best, even for HIV-positive mothers. Available at: http://www.who.int/bulletin/volumes/88/1/10-030110/en/.
Merwe KVD, Hoffman R, Black V, Chersich M, Coovadia A, Rees H. Birth outcomes in South African women receiving highly active antiretroviral therapy: a retrospective observational study. J Int AIDS Soc. 2011;14:42.
United Nations Children’s Fund and World Health Organization, Low Birthweight: Country, regional and global estimates. UNICEF. New York; 2004.
Oliver C EzechiEmail author, Agatha N David, Chidinma V Gab-Okafor, Harry Ohwodo, David A Oladele, Olufunto O Kalejaiye. Incidence of and socio-biologic risk factors for spontaneous preterm birth in HIV positive Nigerian women. BMC Pregnancy and Childbirth 2012, 12:93. Available at:http://www.biomedcentral.com/1471-2393/12/93.
Born too soon: The Global Action Report on Preterm Birth. World Health Organization 2012.
Kumwenda NI, Hoover DR, Mofenson LM, Thigpen MC, Kafulafula G, Qing Li. Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission. N Engl J Med. 2008;359:119-29.
World Health Organization 2011. Policy Brief. Department of reproductive health and research kesho bora study. Preventing mother-to-child transmission of HIV during breastfeeding.
Chibwesha CJ, Giganti MJ, Putta N, Chintu N, Jessica Mulindwa, Dorton BJ. Optimal Time on HAART for Prevention of Mother-to-Child Transmission of HIV. J Acquir Immune Defic Syndr. 2011;58(2):224-8.
Shapiro RL, Hughes, Ogwu A, Kitch D, Lockman S, Moffat C. Antiretroviral regimens in Pregnancyand Breast-Feeding in Botswana. N Engl J Med. 2010;362:2282-94.
WHO programmatic update: use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: executive summary. 2012.