Low rate of mother-to-child transmission of HIV-1 after nevirapine intervention in a pilot public health program in Yaoundé, Cameroon

J Acquir Immune Defic Syndr. 2003 Nov 1;34(3):274-80. doi: 10.1097/00126334-200311010-00003.

Abstract

Objective: To determine the percentage of infected children for whom nevirapine (NVP) was used to prevent peripartum mother-to-child transmission (MTCT) of HIV in Yaoundé, Cameroon.

Design: The study was a prospective Public Health Pilot Program covering a 3-year period (January 2000-December 2002).

Methods: Counseled and consenting HIV-1-positive pregnant women were given a single dose of NVP at the onset of labor. Babies were given 2 mg/kg NVP syrup within the first 72 hours of life. NVP-treated children were regularly followed up and examined for HIV-1 infection at 6-8 weeks and 5-6 months through plasma viral load (VL) quantification with the bDNA system.

Results: One hundred twenty-three children were diagnosed with perinatal HIV-1 infection at 6-8 weeks and 5-6 months. Thirteen children (10.6% [13/123]; 95% confidence interval, 5.1-16) were infected and presented with high VLs, in general >500,000 copies/mL. Two children had intermediate VLs (between 50 and 3500 copies/mL) at both time points. One hundred seven children (87%) were considered not infected at 6-8 weeks of age.

Conclusions: Our results indicate that the HIV-1 MTCT rate 6-8 weeks after NVP administration was not >13% (16/123), thus demonstrating the effectiveness of NVP for lowering the risk of HIV-1 MTCT in real-life settings.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Cameroon / epidemiology
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • HIV Infections / transmission*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification*
  • Humans
  • Immunoenzyme Techniques
  • Infant
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Nevirapine / therapeutic use*
  • Pilot Projects
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Complications, Infectious / virology*
  • Prospective Studies
  • RNA, Viral / blood
  • Statistics, Nonparametric

Substances

  • Anti-HIV Agents
  • RNA, Viral
  • Nevirapine