title: Brief Report: Impact of Option B+ on the Infant PMTCT Cascade in Lilongwe, Malawi.
abstract: This observational study compared uptake of infant prevention of mother-to-child transmission of HIV services pre/post implementation of Option B+ in Lilongwe, Malawi. There were 845 (pre) and 998 (post) births. Post-B+, infants had longer median predelivery maternal antiretroviral therapy {62 days [interquartile range (IQR): 38-94] pre-B+ vs. 95 days [IQR: 61-131] post-B+; P < 0.0001} and improved polymerase chain reaction testing (82.0% vs. 86.5%; P = 0.01) at younger median age [7.6 weeks (IQR: 6.6-10.9) vs. 6.9 (IQR: 6.4-8.1); P < 0.0001]. Proportion testing polymerase chain reaction positive decreased (4.6% vs. 2.6%; P = 0.03). Proportion of HIV-infected infants starting antiretroviral therapy (75% vs. 77.3%) and age at initiation [19.7 weeks (IQR: 15.4-31.1) vs. 16 (IQR: 13.3-17.9)] remained unchanged. These findings suggest modest improvements in infant care with Option B+.
authors: *Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX; †Baylor College of Medicine-Abbott Fund Children's Clinical Center of Excellence, Lilongwe, Malawi; ‡UNC Project, Lilongwe, Malawi; §University of North Carolina School of Medicine, Chapel Hill, NC; ‖Department of Pediatrics, Epidemiology Center, Baylor College of Medicine, Houston, TX; ¶Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi; #ICAP-Columbia University, Mailman School of Public Health, New York, NY; and **College of Physicians and Surgeons, Columbia University, New York, NY.
authors: Maria H
authors: MH
authors: Kim
authors: Saeed
authors: S
authors: Ahmed
authors: Mina C
authors: MC
authors: Hosseinipour
authors: Xiaoying
authors: X
authors: Yu
authors: Chi
authors: C
authors: Nguyen
authors: Frank
authors: F
authors: Chimbwandira
authors: Mary E
authors: ME
authors: Paul
authors: Peter N
authors: PN
authors: Kazembe
authors: Elaine J
authors: EJ
authors: Abrams
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D008297:Male; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents