MothertoChild HIV Transmission Rate in Botswana Analysis of Dried Blood Spot DBS Results from the Na

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Mother-to-Child HIV Transmission Rate in Botswana
- Analysis of Dried Blood Spot (DBS) Results from
the National PMTCT Programme

• Ministry of Health, Botswana
• Department of HIV/AIDS Prevention and Care
• Presenter Dr T. Gaolathe
• J. Tlale, K. Keapoletswe, M.G. Anderson,
• F. de la Hoz Gomez, M. Mmelesi, K. Seipone

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Introduction

• HIV prevalence in Botswana stands around 33,
  between 2005- 2007 among pregnant women aged
  15-49.
• Vertical transmission of HIV constitutes major
  source of pediatric HIV infection.
• ARV (prophylaxis and treatment) is used for
  prevention of mother-to-child transmission
  (PMTCT) of HIV.

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Background

• HIV Positive pregnant women with CD4 count above
  200 are given AZT (Zidovudine) from 28 weeks of
  gestation till labour, and single dose Nevirapine
  (sdNVP) at onset of labour
• Women with CD4 count of 200 or less are given
  HAART (Highly Active anti-retroviral Therapy).
• PMTCT Uptake stood at 90 in 2007

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Methodology

• PMTCT programme data was analyzed from October
  2006- November 2007 on records of HIV test
  results of 10516 children born to HIV positive
  women from all health districts.
• The DBS (Dried Blood Spot) PCR (Polymerase-
  Chain- Reaction) method was used for HIV testing
  (at six weeks).
• Chi-Square test was performed to compare outcomes
  of various drug regimen combinations, based on
  nationally recommended regimen for PMTCT mothers
  data regarding prophylaxis administered to
  infants was not included in this analysis.

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Results
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Discussion

• Efficacy of preventing HIV transmission from
  mother to infant is highest among mothers who
  started HAART before pregnancy.
• Added value of sdNVP when mother received AZT for
  more than four weeks is negligible. However,
  sdNVP reduces vertical transmission by about 40
  compared to mothers who received nothing.

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Discussion contd

• Among other factors, low rate of vertical
  transmission in mothers who took nothing may also
  be related to reduced exposure to breastfeeding
  and its impact, since most HIV positive pregnant
  women in Botswana opt for formula feeding.

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Conclusion

• Overall, the DBS data reveals that HIV
  transmission rate from mother to infant is
  lowest among HIV positive pregnant women
  receiving ARV prophylaxis/ treatment.

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Acknowledgements

• Bodika S
• Jimbo W
• Taffa N
• CDC-BOTUSA Project, Gaborone