Low rate of mother-to-child transmission of HIV-1 after nevirapine intervention in a pilot public health program in Yaoundé, Cameroon.
OBJECTIVE
To determine the percentage of infected children for whom nevirapine (NVP) was used to prevent peripartum mother-to-child transmission (MTCT) of HIV in Yaoundé, Cameroon.


METHODS
The study was a prospective Public Health Pilot Program covering a 3-year period (January 2000-December 2002).


METHODS
Counseled and consenting HIV-1-positive pregnant women were given a single dose of NVP at the onset of labor. Babies were given 2 mg/kg NVP syrup within the first 72 hours of life. NVP-treated children were regularly followed up and examined for HIV-1 infection at 6-8 weeks and 5-6 months through plasma viral load (VL) quantification with the bDNA system.


RESULTS
One hundred twenty-three children were diagnosed with perinatal HIV-1 infection at 6-8 weeks and 5-6 months. Thirteen children (10.6% [13/123]; 95% confidence interval, 5.1-16) were infected and presented with high VLs, in general >500,000 copies/mL. Two children had intermediate VLs (between 50 and 3500 copies/mL) at both time points. One hundred seven children (87%) were considered not infected at 6-8 weeks of age.


CONCLUSIONS
Our results indicate that the HIV-1 MTCT rate 6-8 weeks after NVP administration was not >13% (16/123), thus demonstrating the effectiveness of NVP for lowering the risk of HIV-1 MTCT in real-life settings.
Ayouba
Ahidjo
A
Centre Pasteur du Cameroun, BP 1274, Fondation Chantal Biya, Yaoundé, Cameroon.
Tene
Gilbert
G
Cunin
Patrick
P
Foupouapouognigni
Yacouba
Y
Menu
Elisabeth
E
Kfutwah
Anfumbom
A
Thonnon
Jocelyn
J
Scarlatti
Gabriella
G
Monny-Lobé
Marcel
M
Eteki
Nicole
N
Kouanfack
Charles
C
Tardy
Michèle
M
Leke
Robert
R
Nkam
Maurice
M
Nlend
Anne E
AE
Barré-Sinoussi
Françoise
F
Martin
Paul M V
PM
Nerrienet
Eric
E
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000627:therapeutic use*; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D018709:Statistics, Nonparametric
D019380:Anti-HIV Agents; D012367:RNA, Viral; D019829:Nevirapine