Effective program against mother-to-child transmission of HIV at Saint Camille Medical Centre in Burkina Faso

✍ Scribed by J. Simpore; V. Pietra; S. Pignatelli; D. Karou; W.M.C. Nadembega; D. Ilboudo; F. Ceccherini-Silberstein; W.N. Ghilat-Avoid-Belem; M.C. Bellocchi; N. Saleri; M.J. Sanou; C.M. Ouedraogo; J.B. Nikiema; V. Colizzi; C.P. Perno; F. Castelli; S. Musumeci

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 112 KB
• Volume: 79
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.20913

✦ Synopsis

Abstract

The present research was aimed to prevent mother‐to‐child transmission of HIV; to use RT‐PCR in order to detect, 6 months after birth, infected children; and to test the antiretroviral resistance of both children and mothers in order to offer them a suitable therapy. At the Saint Camille Medical Centre, 3,127 pregnant women (aged 15–44 years) accepted to be enrolled in the mother‐to‐child transmission prevention protocol that envisages: (i) Voluntary Counselling and Testing for all the pregnant women; (ii) Antiretroviral therapy for HIV positive pregnant women and for their newborns; (iii) either powdered milk feeding or short breast‐feeding and RT‐PCR test for their children; (iv) finally, pol gene sequencing and antiretroviral resistance identifications among HIV positive mothers and children. Among the patients, 227/3,127 HIV seropositive women were found: 221/227 HIV‐1, 4/227 HIV‐2, and 2/227 mixed HIV infections. The RT‐PCR test allowed the detection of 3/213 (1.4%) HIV infected children: 0/109 (0%) from mothers under ARV therapy and 3/104 (2.8%) from mothers treated with Nevirapine. All children had recombinant HIV‐1 strain (CRF06_CPX) with: minor PR mutations (M36I, K20I) and RT mutations (R211K). Among them, two twins had Non‐Nucleoside Reverse Transcriptase Inhibitor mutation (Y18CY). Both mothers acquired a major PR mutation (V8IV), investigated 6 months after a single‐dose of Nevirapine. Prevention by single‐dose of Nevirapine reduced significantly mother‐to‐child transmission of HIV, but caused many mutations and resistance to antiretroviral drugs. Based on present study the antiretroviral therapy protocol, together with the artificial‐feeding, might represent the ideal strategy to avoid transmission of HIV from mother‐to‐child. J. Med. Virol. 79:873–879, 2007. © 2007 Wiley‐Liss, Inc.