Abstract
Background: Despite efforts to fight, HIV/AIDS mother-to-child transmission of HIV-1 (MTCT), as well as abortion and infant mortality, remains a problem in sub-Saharan Africa. Indeed, a low level of CD4 and a high viral load can be associated with these situations. The aim of this study was to determine the risk factors associated with the occurrence of MTCT, spontaneous abortion and infant mortality in HIV-1 infected women in Ouagadougou, Burkina Faso. This was a prospective study conducted from May 2014 to September 2017 and involved 423 HIV-1 infected women followed at Saint Camille Hospital in Ouagadougou, Burkina Faso. Sociodemographic data were collected through a questionnaire. The CD4 count and HIV-1 viral load were determined using respectively BD FACSCount and Abbott m2000rt instruments. Bivariate analysis and multinomial logistic regression were performed for associations with a significance threshold for p < 0.05. Results: The average age of women was 38.75 ± 7.98 years. Rates of MTCT, abortion and infant mortality were 16.31%, 30.49% and 34.75%, respectively. The number of pregnancies was associated with the number of infant deaths (p = 0.002). A correlation between the number of pregnancies and infant mortality was observed (p = 0.002) with a relatively high rate (28.6%) among women who had three pregnancies. In addition, marital status was associated with HIV-1 infection in infants (p = 0.042) and spontaneous abortion (p = 0.033). HIV-1 infected women with low CD4 counts (less than 350 cells/μL) and those with viral load more than 1000 copies/mL were about twice as likely to have an spontaneous abortion [OR (IC 95%): 2.50 (1.085 - 5.760); p = 0.03] and [OR (95% CI): 2.16 (1.043 - 4.505); p = 0.04]. Conclusions: The results of this study show the need to improve the treatment of HIV-1 infected women in order to restore CD4 levels and make viral load of HIV-1 undetectable.
Highlights
Human immunodeficiency virus type 1 (HIV-1) continues to affect many people worldwide despite prevention and antiretroviral therapy (ART)
40.4% of women had a CD4 count less than 350 cell/ μL while 44.7% had a plasma viral load more than 1000 copies/mL. 2) Rates of mother-to-child transmission of HIV-1 (MTCT), spontaneous abortion and death of children This study reported a mother-to-child transmission rate of 16.31% (69/423)
3) MTCT, number of spontaneous abortions and number of deceased children according to sociodemographic parameters Analysis of the results showed a significant difference between the number of pregnancies and the number of spontaneous abortions (p < 0.001)
Summary
Human immunodeficiency virus type 1 (HIV-1) continues to affect many people worldwide despite prevention and antiretroviral therapy (ART). When the HIV status of the pregnant woman is known, midwives can take precautions to avoid possible complications that may lead to transmission of the virus to the baby during delivery Despite these preventive measures, some children may be infected either during pregnancy, childbirth or breastfeeding [6] [7] [8]. Several studies have shown that age, undetectable viral load, and high CD4 T-cell counts were associated with reproductive desire in couples living with HIV-1 [9] [10]. The aim of this study was to determine the risk factors associated with the occurrence of MTCT, spontaneous abortion and infant mortality in HIV-1 infected women in Ouagadougou, Burkina Faso. Conclusions: The results of this study show the need to improve the treatment of HIV-1 infected women in order to restore CD4 levels and make viral load of HIV-1 undetectable
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