Qualitative Detection of Proviral-DNA of HIV-1 in Infants to Determine the Efficacy of Antiretroviral Therapy in the Prevention of Vertical Transmission of HIV-1 in The Gambia

Lamin B Cham,Ebrima Joof,Musa Ceesay,Pa Ousman Bah,Abou Kebbeh,Bakary Sanneh,Pape Mbacké Sembene,Ebrima Njie,Massamba Gueye

doi:10.4236/wja.2016.64019

Abstract

The priority of The Gambia government is to eliminate maternal to child transmission of HIV and in line with this priority, the country implemented an antiretroviral therapy (ART) program. With this, all HIV infected pregnant and breastfeeding mothers and infants have access to ARV drugs. This study aims to determine the prevalence of vertical transmission of HIV among women receiving the ARV drugs. Dried blood spot samples were collected from 109 HIV-exposed infants enrolled in 13 PMTCT sites across the country. A qualitative detection of proviral-DNA of HIV-1 was performed using the RealTime Abbott PCR assay. Data from 105 mothers were analyzed using SPSS version 16.0 and association of risk factors to PCR results were analyzed using (Crosstabs) Pearson Chi-Square. The p-value of significant was set at p < 0.05. This study has found that the prevalence of vertical transmission of HIV is 0.0% (0/64) among women that received the ARV prophylaxis then started ART, 7.1% (2/28) among mothers that received HIV prophylaxis only, and 38.4% (5/13) among women who neither receive HIV-prophylaxis nor ART during pregnancy or breastfeeding. Other risk factors of vertical transmission such as late initiation of treatment, default during treatment and first born of twins were found to be significantly associated with vertical transmission p = 0.001, p = 0.022 and p = 0.000 respectively. This study has found that the early intervention of ART at the onset of pregnancy through breastfeeding can eliminates Maternal to Child transmission of HIV-1and a high risk of vertical transmission was found among women who neither receive prophylaxis nor ART. If the effectiveness of the antiretroviral therapy is maintain, The Gambia, in the near future will attain the WHO’s goal to eliminate maternal to child transmission of HIV.

Highlights

The climatic and other environmental factors of the African continent encourage the adaptation and survival of most micro-organisms
This study has found that the prevalence of vertical transmission of Human Immunodeficiency Virus (HIV) is 0.0% (0/64) among women that received the ARV prophylaxis started antiretroviral therapy (ART), 7.1% (2/28) among mothers that received HIV prophylaxis only, and 38.4% (5/13) among women who neither receive HIV-prophylaxis nor ART during pregnancy or breastfeeding
This study has found that the early intervention of ART at the onset of pregnancy through breastfeeding can eliminates Maternal to Child transmission of HIV-1and a high risk of vertical transmission was found among women who neither

Summary

Introduction

The climatic and other environmental factors of the African continent encourage the adaptation and survival of most micro-organisms (pathogens inclusive). This has caused infectious diseases to be a major challenge in the socio-economic status of countries in the Sub-Saharan Africa. The Human Immunodeficiency Virus (HIV) is an etiological cause of Acquired Immunodeficiency Syndrome (AIDS) [1] [2] [3] [4] which is a major worldwide threat in Africa as it continues to claim millions of lives and still remind incurable. Over 35.4 million people are living with the HIV and about 63% - 70% of the HIV infected individuals at the end of 2012 are living in Sub-Saharan Africa [5] [6]. It is estimated that roughly there are 7000 new HIV infections every day and nearly 97% of these, come from developing countries and about 60% are from Sub-Saharan Africa [4]

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