Can we prevent pediatric HIV? An experience at a tertiary care hospital.

BACKGROUND: Parent-to-child transmission (PTCT) is the commonest mode of acquiring HIV in more than 90% children. The risk during pregnancy varies from 20 to 45% and with specific interventions in mother and baby; it can be reduced to less than 2%. This study was conducted to assess the efficacy of comprehensive PPTCT programme.

METHOD: This descriptive study was conducted at a tertiary care hospital, from Jan 2008 till Jul 2010. 32 HIV-positive pregnant mothers were enrolled in the study. They were evaluated, given triple drug antiretroviral therapy and followed up. Babies were given single dose nevirapine and zidovudine till 6 weeks of age. DNA-PCR was done for confirming the HIV status of baby.

RESULTS: The yearly period prevalence of pregnant mothers found HIV positive at antenatal clinic showed a downward trend, from 0.39% in 2008 to 0.18% in 2010. Mean CD4 count of mothers at diagnosis was 459.41 [SD - 238.37]. Twenty eight mothers (93.3%) received antiretroviral therapy. 15 (50%) babies were delivered by cesarean section and 26 infants were given replacement feeding. All the babies were singletons, 29 (96.7%) born at term with an average birth weight of 2.60 kg (SD = 0.5) and male to female ratio of 0.87:1. Twenty nine (96.7%) infants were declared HIV-negative and parent-to-child transmission rate at our center was 3.3%.

CONCLUSION: A comprehensive PPTCT programme with administration of antiretroviral therapy to the mother and infant, safe delivery practices, avoidance of breastfeeding, and close follow up, the incidence of PTCT can be reduced to negligible rates as seen in our study.