title: Reduced HIV transmission at subsequent pregnancy in a resource-poor setting.
abstract: Several studies indicate that HIV-infected women continue to have children. We set out to determine the trend in HIV transmission at subsequent pregnancies. From 2002-2003, pregnant women were enrolled in a single dose nevirapine-based Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme. Six years later, women with subsequent children in this cohort were identified and their children's HIV status determined. From 330 identified HIV-infected mothers, 73 had second/subsequent children with HIV results. Of these, nine (12.3%, 95% confidence interval [CI]: 4.6-20.1%) children were HIV-infected. Of the 73 second children, 51 had older siblings who had been initially enrolled in the study with definitive HIV results with an infection rate of 17/51 (33.3%, 95% CI: 19.9-46.7). About 35% of the women had been on antiretroviral drugs. These results demonstrate lower subsequent HIV transmission rates in women on a national PMTCT programme in a resource-poor setting with the advent of antiretroviral therapy.
authors.affiliation: Department of Paediatrics and Child Health, College of Health Sciences, University of Zimbabwe, P Bag A178, Avondale, Harare, Zimbabwe. zvanyadz@mweb.co.zw
authors.forename: Felicity Zvanyadza
authors.initials: FZ
authors.lastname: Gumbo
authors.forename: Gwendoline Quintoline
authors.initials: GQ
authors.lastname: Kandawasvika
authors.forename: Kerina
authors.initials: K
authors.lastname: Duri
authors.forename: Munyaradzi Paul
authors.initials: MP
authors.lastname: Mapingure
authors.forename: Nyaradzai Edith
authors.initials: NE
authors.lastname: Kurewa
authors.forename: Kusum
authors.initials: K
authors.lastname: Nathoo
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.forename: Mike Zvavahera
authors.initials: MZ
authors.lastname: Chirenje
authors.forename: Babill
authors.initials: B
authors.lastname: Stray-Pedersen
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000401:mortality / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage; D011203:Poverty; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D015397:Program Evaluation; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage; D016896:Treatment Outcome; D015030:Zimbabwe
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine