title: Timely antiretroviral prophylaxis during pregnancy effectively reduces HIV mother-to-child transmission in eight counties in China: a prospective study during 2004-2011.
abstract: This study investigates the improvement of the prevention of mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) in China during 2004-2011. A clinic-based prospective study was conducted among HIV-positive pregnant women and their children in eight counties across China. Associated factors of mother-to-child transmission were analyzed using regression analysis. A total of 1,387 HIV+ pregnant women and 1,377 HIV-exposed infants were enrolled. The proportion of pregnant women who received HIV testing increased significantly from 45.1% to 98.9% during 2004-2011. Among whom, the proportion that received antiretroviral (ARV) prophylaxis increased from 61% to 96%, and the corresponding coverage in children increased from 85% to 97% during the same period. In contrast, single-dose nevirapine treatment during delivery declined substantially from 97.9% to 12.7%. Vertical transmission of HIV declined from 11.1% (95% confidence interval [CI]: 5.7-23.3%) in 2004 to 1.2% (95% CI: 0.1-5.8%) in 2011. Women who had a vaginal delivery (compared to emergency caesarian section (odds ratio [OR] = 0.46; 0.23-0.96)) and mothers on multi-ARVs (OR = 0.11; 0.04-0.29) were less likely to transmit HIV to their newborns. Increasing HIV screening enabled timely HIV care and prophylaxis to reduce vertical transmission of HIV. Early and consistent treatment with multi-ARVs during pregnancy is vital for PMTCT.
authors.affiliation: National Center for women and children's health, China Center for Disease Control and prevention, Beijing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.affiliation: National Center for Chronic and Non-communicable Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Linhong
authors.initials: L
authors.lastname: Wang
authors.affiliation: National Center for Chronic and Non-communicable Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: Liwen
authors.initials: L
authors.lastname: Fang
authors.affiliation: National Center for women and children's health, China Center for Disease Control and prevention, Beijing, China.
authors.forename: Ailing
authors.initials: A
authors.lastname: Wang
authors.affiliation: National Center for women and children's health, China Center for Disease Control and prevention, Beijing, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Jin
authors.affiliation: National Center for women and children's health, China Center for Disease Control and prevention, Beijing, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.affiliation: National Center for women and children's health, China Center for Disease Control and prevention, Beijing, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Wang
authors.affiliation: National Center for women and children's health, China Center for Disease Control and prevention, Beijing, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Qiao
authors.affiliation: WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia.
authors.forename: Sheena G
authors.initials: SG
authors.lastname: Sullivan
authors.affiliation: Affiliation Centre for Environment and Population Health, Griffith University, Australia.
authors.forename: Shannon
authors.initials: S
authors.lastname: Rutherford
authors.affiliation: Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.|Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.|School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.|Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D019829:Nevirapine / Q000008:administration & dosage*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine