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

Simpore J, Pietra V, Pignatelli S, Karou D, Nadembega WM, Ilboudo D, Ceccherini-Silberstein F, Ghilat-Avoid-Belem WN, Bellocchi MC, Saleri N, Sanou MJ, Ouedraogo CM, Nikiema JB, Colizzi V, Perno CP, Castelli F, Musumeci S.

J Med Virol. 2007 Jul ;79(7):873-9.
PMID : 17516517 [PubMed - indexed for MEDLINE]



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.

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