A Study on Maternal Viral Load, CD4 Cell Counts and Time of Mother-to-Child Transmission of HIV-1 in Two Hospitals in Central Ethiopia

Abstract

Background: Vertical transmission of HIV among women who have no access to ART is estimated to be 25% - 35% in Africa. Objective: The aim of the study was to assess the time of MTCT of HIV-1 the efficacy of ART on prevention of mother-to-child transmission (MTCT) of HIV-1 in two hospitals. Methods: Prospective cohort study was conducted from November 2011 to May 2012. A total of 162 participants, 81 mothers (24 non-breastfeeding and 57 breastfeeding) and 81 infants were involved in the study. Venous blood from mothers and heel blood (dried blood spot) from infants were collected and processed in Adama Regional laboratory. All dried blood spot specimens of infants reactive on ELISA test were assessed by DNA-based polymerase chain reaction tests (DNA PCR) to determine HIV infection. Data were entered and analysed using SPSS version 19 computer software. Results: Five infants were infected with HIV at the end of this study. The overall rate of vertical transmission of HIV was 6.2%. Maternal viral load at delivery was independently associated with both in-utero and intra-partum transmission (OR = 27.0, 95% CI, 3.5 - 210, p = 0.001). Maternal viral load at 6 weeks of birth and low infant birth weight was associated with intra-partum transmission among breastfeeding mothers (OR = 25.5, 95% CI, 1.14 - 572, p = 0.04) and (OR = 29.6, 95% CI, 3.2 - 273, p = 0.004), respectively. There were 40% MTCT of HIV among non ARV drug users and only 3.9% among those used ARV drugs during their current pregnancy. Conclusion: Strategies planned to reduce maternal viral load during pregnancy can be successful in substantially reducing vertical transmission of HIV. In addition, other contributing factors for MTCT of HIV-1 should be controlled.