Background In resource limited settings, effectiveness of PMTCT programmes and ART outcomes in HIV infected neonates remains poorly documented. The study aimed at evaluating the efficacy of PMTCT programmes in 10 maternities in Kenya and to describe outcomes in HIV-infected neonates.
Methods HIV-exposed neonates were screened at birth at week 6. Heel prick samples of blood on DBS were used for DNA real time PCR testing. HI-RNA viral load and ARV drug resistance genotyping were done accordingly.
Results Between 2008 and 2011. 1,000 exposed neonates were screened for HIV infection. 60% were born from mothers on Tritherapy, 20% from mothers receiving dual AZT/sdNVP therapy, and 12% to mothers receiving only sdNVP. 70% of neonates received sdNVP at birth. All neonates were formula fed exclusively. Seven were diagnosed HIV+ at birth (Utero transmission rate = 0.91%). 55% were lost of 5 of follow up and 5 died before week 7. 15/900 were diagnosed positive at week 7 (peri partum transmission rate = 1.80%). 17/24 infected neonates started ART. Virological follow-up indicated that 8/11 reached undetected VL whereas 4/13, representing resistance to RTIs (one pre-ART, 2 Post ART), were in treatment failure. 9/22 (40.1%) infected-neonates were successfully treated.
Conclusion The study highlights the feasibility and interest of the very early infant diagnosis, illustrates the efficacy of PMTCT interventions and clearly points out the difficulties faced to treat effectively infected neonates.
- antiretroviral therapy
- HIV infection
- prevention of mother to child transmission