Incidence of Vertical-Transmission of HIV and Its Correlation with Maternal Gestational Age at Antenatal Booking in Port-Harcourt, Nigeria

Background: Pregnancy associated with human immunodeficiency virus (HIV)- infection poses risk to the fetus due to vertical-transmission. This can be prevented through administration of antiretroviral drugs. Our objective was to investigate the incidence of vertical-transmission of HIV and its correlation with maternal gestational age at antenatal booking with immediate commencement of antiretroviral therapy in Port-Harcourt, Nigeria.

Methods: All antenatal attendees and their HIV-exposed newborns were screened for HIV-infection between April, 2016 and May, 2017 using qualitative rapid ELISA kits and HIV-DNA PCR technique. The HIV-positive antenatal attendees were placed on daily single-dose triple antiretroviral regimen (efavirenz, lamivudine, tenofovir, 600/300/300mg tablet) with multivitamins from the first day of booking and continued afterward. The HIV-exposed babies were placed on 5ml daily single-dose triple antiretroviral chemoprophylaxis on the first day of delivery and continued until blood collection at 6 weeks for HIV diagnosis. Statistical Package for Social Science (SPSS) software (version 17.0) was used for data analysis.

Results: We found 4.34% overall prevalence of HIV-1 infection among the antenatal attendees and 7.57% incidence of mother-to-child transmission. There was significant difference between gestational age at booking with commencement of ART and the number of HIV-positive babies (χ2=7.113, df=2, P<0.05). There was no vertical transmission among the attendees who booked at first trimester, 35.7% at second trimester and 64.3% at third trimester. There was no statistically significant gender difference (P>0.05) between the number of infected males, 42.9% and females, 57.1%.

Conclusion: High incidence of vertical-transmission of HIV was obtained from those HIV-positive mothers who registered late for antenatal care. Therefore, strong advocacy for early entry into antenatal care is solicited.