title: Virtual Elimination of Mother-to-Child Transmission of Human Immunodeficiency Virus in Mothers on Highly Active Antiretroviral Therapy in Enugu, South-Eastern Nigeria.
abstract: BACKGROUND
  With the current World Health Organization (WHO) "Option B+" for prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV), virtual elimination of mother to child transmission (eMTCT) is highly achievable.
  
  
  OBJECTIVE
  The aim of this study is to determine the rate of MTCT of HIV from mothers who started highly active antiretroviral therapy (HAART) for life from diagnosis during pregnancy to the exposed babies who had daily nevirapine in the first 6 weeks of life.
  
  
  METHODS
  HIV positive mothers and their exposed babies who enrolled for the hospital PMTCT protocol from January 1, 2009 to December 31, 2011 were studied. The babies were tested for HIV using deoxyribo nucleic acid polymerase chain reaction test at 6 weeks, and then HIV rapid tests at 18 months.
  
  
  RESULTS
  A total of 5,946 booked mothers had HIV testing and counseling (HTC) within the study period. Two hundred and twenty-three (223/5946, 3.7%) were positive, out of which 188 (188/223, 84.3%) enrolled for the PMTCT interventions while 35 (35/223, 15.7%) did not enroll. Three of the enrollees were lost to follow up and two were referred to another PMCT center. Of the remaining 183 enrolled HIV positive mothers, one gave birth to a set of twins, giving a total of 184 exposed babies. There were two cases of intrauterine fetal death of unknown fetal HIV status. None of the 182 remaining babies evaluated for HIV testing tested positive to HIV.
  
  
  CONCLUSIONS
  With adequate suppression of maternal viral replication with HAART using the WHO Option B+, eMTCT of HIV is achievable in a developing country like Nigeria where infant breastfeeding is a norm.
authors.affiliation: Department of Obstetrics and Gynecology, Enugu State University of Science and Technology Teaching Hospital, Parklane, Enugu, Nigeria.
authors.forename: Ii
authors.initials: I
authors.lastname: Okafor
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria, Enugu, Enugu State, Enugu Campus/University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.
authors.forename: Eo
authors.initials: E
authors.lastname: Ugwu
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria, Enugu, Enugu State, Enugu Campus/University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.
authors.forename: Sn
authors.initials: S
authors.lastname: Obi
authors.affiliation: Department of Obstetrics and Gynecology, Enugu State University of Science and Technology Teaching Hospital, Parklane, Enugu, Nigeria.
authors.forename: Bu
authors.initials: B
authors.lastname: Odugu
keywords: Developing country; Elimination of mother to child transmission; Highly active antiretroviral therapy; Human immunodeficiency virus