Utilization of therapeutic intervention to prevent mother to child transmission of HIV in a teaching hospital in Kolkata, India.
OBJECTIVE
To assess the uptake of an HIV screening program and therapeutic intervention to minimize the risk of mother to child transmission.


METHODS
This was a cross-sectional, observational study with retrospective data obtained from patient medical records. Pregnant women presenting to a tertiary care center in Kolkata, India, from 1 January 2004 - 31 December 2007 underwent HIV serology by rapid test after receiving group counseling. Care was administered using a standard national protocol by a multi-disciplinary team of health-care personnel. Main outcome measures were: acceptance of pretest counseling and HIV testing by pregnant women attending antenatal clinic services, post-test counseling rate, coverage rate of nevirapine to mother-child pairs, and averted HIV infection in children.


RESULTS
Of the 52 127 new antenatal booking visits, 49 580 (95.11%) women attended pretest counseling and 47 506 (91.13%) women accepted HIV testing. Eighty-six women were found to be seropositive. The seroprevalence rate of HIV infection was 0.17%. Thirty-seven mothers (88%) and all newborn infants (100%) had received nevirapine prophylaxis. Overall nevirapine coverage rate was 48%. Twenty-four of the mother-infant pairs that we assessed had infants who were aged over 18 months by June 2008. Eleven (45.83%) of these women turned up with their babies for a blood test at 18 months. Three (27.27%) babies tested reactive.


CONCLUSIONS
As uptake of testing is high and detection of HIV-infected women in pregnancy remains very low, a radical rethinking of policies on therapeutic intervention and their implementation now needs to be undertaken.
Chaudhuri
Snehamay
S
Department of Obstetrics & Gynecology, NRS Medical College, West Bengal State AIDS Control and Prevention Society, Kolkata, India. snehamay_chaudhuri_dr@yahoo.com
Mundle
Malay
M
Konar
Hiralal
H
Das
Chandana
C
Talukdar
Arunansu
A
Ghosh
Uday Sankar
US
D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity / Q000188:drug therapy / Q000635:transmission*; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy; D011295:Prenatal Care; D012189:Retrospective Studies