title: Outcome of Prevention of Parent-to-Child Transmission of HIV in an Urban Population in Southern India.
abstract: OBJECTIVE
  To analyze the outcomes of Prevention of Parent to Child Transmission (PPTCT) of HIV program in an urban Southern Indian setting.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Anti-retroviral Therapy (ART) Centers/ Integrated Counseling and Testing Centers (ICTC) at four government Obstetrics Institutes in an urban area.
  
  
  METHODS
  100 HIV-positive pregnant women and their infants delivered in the study centers.
  
  
  METHODS
  Triple drug ART to HIV-positive pregnant women was started for maternal indications only. Rest of the pregnant women were given single dose Nevirapine (200 mg) at the onset of labor. All infants were given single dose Nevirapine (2 mg/kg) prophylaxis, according to National AIDS Control Organization guidelines. Mothers were counseled regarding breastfeeding and artificial feeding, and the choice was left to them. Whole blood HIV 1 DNA PCR was done for all infants at 6 weeks of life. A second PCR was done at 6 months or 6 weeks after stopping breastfeeds. PCR-positive infants were started on ART, and were followed-up till18 months of life.
  
  
  RESULTS
  Four infants were PCR-positive for HIV. All of them were breastfed. They were born to mothers of HIV stage 1 or 2 who were not on ART as CD4 counts were >350 cells/mm3. Among the mothers in Stage 3 or 4 or CD4 count <200 cells/mm3 and on ART, none of the infants was HIV-positive. The cumulative HIV-free survival at 18 months was 94%.
  
  
  CONCLUSIONS
  Parent-to-child transmission rate in HIV was low with the currently used strategies. Triple drug ART to mother reduces mother-to-child transmission despite advanced maternal stage or low CD4 counts.
authors.affiliation: Department of Pediatrics, Government Kilpauk Medical College, and *National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre); Chennai, India. Correspondence to: Dr S Seenivasan, 28, Indra Nagar, Walajah Road, Sholinghur, Vellore, Tamilnadu 631 102, India. seeni.sholing@gmail.com.
authors.forename: Subramani
authors.initials: S
authors.lastname: Seenivasan
authors.forename: Natarajan
authors.initials: N
authors.lastname: Vaitheeswaran
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Seetha
authors.forename: Selvaraj
authors.initials: S
authors.lastname: Anbalagan
authors.forename: Ramesh
authors.initials: R
authors.lastname: Karunaianantham
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control* / Q000821:virology; D015497:HIV-1; D006801:Humans; D007194:India / Q000453:epidemiology; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D014505:Urban Population / Q000706:statistics & numerical data*; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine