Short-term outcomes of paired HIV-exposed formula-fed infants and their mothers on HAART in a Nigerian resource-constrained specialist hospital: a cohort study

Terhemen Joseph Igbudu, Olubukunola Inyang, Remen Longmut, Livinus Egwuda

Abstract


Background: Human Immunodeficiency Virus (HIV) has worsened infant mortality in developing countries. These deaths are associated with Low Birth Weight (LBW), varying morbidities and high transmission rate of HIV from mother to her baby. This study assesses the short-term outcome of paired formula-fed infants born to their paired mothers on HAART.

Methods: A cohort study of sixty five paired mothers and their babies attending Prevention of Mother To Child Transmission (PMTCT) clinic for 6 weeks after delivery. The data collected was analyzed using Epi info 3.3.2 version.

Results: All the paired mothers had live births. There were no intra-uterine foetal death, still-births and no pre-term deliveries reported. About 12 (18.5%) of these babies had their birth weight <2.5 kg (LBW). Only 1 (1.5%) baby was positive to PCR-DNA test at six weeks of age. Varying morbidities were reported in 39 (60.0%) of the babies and respiratory tract infection, ophthalmia neonatorum, diarrhoea and malaria were the commonest observed. There was no statistical significant association between transmission of HIV from mother to child and maternal time of initiation of HAART (CI-95%, RR-0.9778, Fishers exact-0.6923). There was also no statistical significant association between transmission rate of HIV and mode of delivery (CI-95%, Fisher exact-0.8461).

Conclusions: The use of HAART in HIV sero-positive mothers was shown to have favourable infants’ outcome. It is hoped that this work will improve quality of care by primary care physicians and open more opportunities of up-take of PMTCT programme by affected families.


Keywords


HIV-exposed infant, Formula-fed, Short-term outcomes, Family

Full Text:

PDF

References


Ekouevi DK, Coffie P, Becquet R, Tonwe-Gold B, Horo A, Thiebaut R, et al. HAART, Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Cote d'Ivoire. AIDS. 2008;22(14):1815-20.

Ma Chado ES, Hefer CB, Costa TT, Nogueira, Oliveira RH, Abreu TF, et al. Pregnancy outcome in women infected with HIV-1 receiving combination antiretroviral therapy before verses after conception. Sex Transm Infect. 2009;85(2):82-7.

Fabiola M, Graham PT. Increased rates of preterm delivery are associated with the initiation of highly active antiretrovial therapy during pregnancy: a single-centre cohort study. J Infect Dis. 2007;196:558-61.

Boer K, Nellen JF, Patel D, Timmermans S, Tempelman C, Wibaut M, et al. The AmRo study: pregnancy outcome in HIV-1 infected women under effectively active antiretroviral therapy and a policy of vaginal delivery. Int J Obstet Gynaecol. 2007;114(2):148-55.

Neale T, Writer S. Pregnancy outcomes not influenced by HAART. Society for maternal-foetal medicine meeting, February 2009. Available at: www.medpagetoday.com/meetingCoverage/SMFM/12773. Accessed 02 July 2009.

Kurewa EN, Gumbo FZ, Munjoma MW, Mapingure MP, Chirenje MZ, Rusakaniko S, et al. Effects of maternal HIV status on infant mortality: evidence from a 9-month follow-up of mothers and their infants in Zimbabwe. J Perinatol. 2010 Feb;30(2):88-92.

Becquet R, Bequet L, Ekouevi DK, Viho I, Shakarovitch C, Fassinou P, et al. Two-year morbidity-mortality and alternatives to prolong breastfeeding among children born to HIV-infected mothers in Cote d’Ivoire. PLoS Med. 2007;4(1):139-51.

Nacro B, Benao L, Barro M, Gaudreault S, Meda N, Msellati P. Feeding choices and morbidity and mortality among children born to HIV-1 infected mothers during the first 6 months of life in the Bobo-Dioulasso (Burkina Faso). J Pediatr Infect Dis. 2010;5(1):37-47.

Tahe TE. Mother-to-child transmission of HIV-1 in Sub-Saharan Africa. Past, present and future challenges. Life Sci. 2010;4(2):3-7.

Homsy J, Moore D, Barasa A, Were W, Likicho C, Waiswa B, et al. Breastfeeding, mother-to-child HIV transmission and mortality among infants born to HIV-infected women on highly active antiretroviral therapy in rural Uganda. J Acquir Immune Defic Syndr. 2010;53(1):28-35.

FHI and USAIDS. Preventing mother-to-child transmission of HIV-A strategic framework, 2004. Available at: http://www.fhi360.org/sites/default/files/media/documents/FPPMTCTenrh1.pdf. Accessed 17 January 2011.

Amosu AM, Atuloah NOS, Olanrewaju MF, Akintunde TI, Babalola AO, Akinnuga AM, et al. Retrospective study of some factors influencing delivery of low birth weight babies in Ibadan, Oyo State, Nigeria. Sci Res Essays. 2011;6(2):236-40.

Watts DH, Lu M, Thompson B, Tuomala RE, Meyer WA, Mendez H. Treatment interruption after pregnancy: effects on diseases progression and laboratory findings. Infect Dis Obstet Gynaecol. 2009;9(1):10-5.

Onah HE, Ibeziako N, Nkwo PO, Obi SN, Nwankwo TO. Voluntary counselling and testing (VCT) uptake, nevirapine use and infant feeding options at the University of Nigeria Teaching Hospital. J Obstet Gynaecol. 2008;28(3):276-9.

Weinbergab A, Forster-Harwooda J, Mc Farlanda EJ, Pappasc J, Davies JK, Kinzieb K, et al. Resistance to antiretrovirals in HIV-infected pregnant women. J Clin Virol. 2009;45(1):39-42.

Clayden P. Low transmission rates and favourable pregnancy outcomes reported in the DREAM study. HIV Treat Bull. 2009;10 (9/10):10.

Shah I. HIV and pregnancy. Is vaginal delivery a safe and viable option? Indian Paediatr. 2008;45:603-4.