Low Prevalence and Risk Factors Related to HIV-1 Mother to Child Transmission under Option B+ Program at 3 Referral Military and Public Hospitals in Cameroon

Abstract

Immunodeficiency Virus type 1 (HIV-1) Mother-To-Child Transmission (MTCT) prevalence and its predictors. Following the limited success achieved with the previous MTCT prevention programs, the Cameroon’s public health ministry adopted in 2014 the Option B+ program that recommends a systematic lifelong treatment to all HIV positive pregnant woman. Study Design: A case-control study was conducted within two groups: a reference group constituted of exposed infants from HIV positive mothers undergoing Option B+ program, and a control group of infants from Anti-Retroviral Treatment (ART) naive HIV positive mothers during pregnancy. Place and Duration of Study: Douala and Yaounde Military Hospitals (HMR2 and HMR1 respectively) as well as the Bertoua Regional Hospital (HRB), From October 2017 to March 2018. Methodology: This research included infected mother - exposed child pairs. Infected mothers’ sociodemographic and clinical characteristics were reported. Infants sampled at six weeks at the HIV MTCT prevention units were tested at the Military Health Research Center for HIV-1 RNA early detection through rtPCR with Abbott m2000sp automated system. Multivariate logistic regression model was built to assess the predictors of MTCT and to compare groups. Results: Within the study period, the overall HIV-1 prevalence in the 107 six weeks old reference group infants and 23 control group infants was nil and 4.35% (1/23) respectively. Logistic regression showed that predictors of HIV-1 MTCT were: home delivery p=0.03 and absence of ART during pregnancy p = 0.04. Conclusion: Vertical transmission of HIV-1 infection is more likely in ART naïve pregnant women as compared to their counterparts established on ART. Hence, implementation of the Option B+ appear to be very essential in eliminating HIV-1 MTCT. Consequently, a systematic enrolment of these pregnant women living with HIV if scaled up, would be very instrumental in eliminating HIV-1 MTCT in Cameroon.