A Survey Confirms the Potency of Nevirapine in Preventing HIV Transmission from Mother to Child in Non Immunosuppressed Women

The aim of this survey was to analyze the constraints of implementing on a larger scale the protocol of prevention of HIV from mother to child by nevirapine (Viramune) intake. This survey takes stock of the components of the children medical care follow-up.

Presented in this article is a straight line survey on 231 newborns from 222 screened mothers during pregnancy in 36 Health Centers in Cotonou and suburbia.

Nevirapine has been administered in a single dose of 200 mg to mothers during labor and a dosage of 7 mg to the infant at birth. These infants have been steadily followed-up from 13 June 2000 to 30 April 2002.

Exclusive feeding either on artificial milk or breastfeeding and a premature weaning at four months of age have been recommended. PCR screening has been conducted at one and six months of age or one month after the effective weaning. Cotrimoxazole has been systematically administered at six weeks.

Results

HIV/AIDS seroprevalence was globally evaluated at 4% in the screened pregnant women. One hundred and ninety seven mothers and children have effectively benefited from nevirapine intakes and this protocol has been adequately observed in 51% cases.

The medical check-up rate was 18.5%. The average age of children under medical care was 10.8 months at the end of the study.

The mother-to-child transmission rate was globally estimated at 20.4% and 7% in an optimal situation (the protocol was observed and the rate of CD(4) above 500).

In case of breastfeeding exclusively followed by a premature weaning in most cases, the average age of effective weaning was 8.3 months.

Twenty-three children died during medical care follow-up basically from dehydration brought about by diarrhea and vomiting during weaning period.

Conclusion

The authors conclude, “The survey confirms the potency of nevirapine in preventing HIV transmission from mother to child in non immunosuppressed women and lays emphasis on real problems for which appropriate solutions should be found before the implementation of this protocol on a larger scale.

Service de pediatrie, CNHU, Cotonou, Benin.

01/12-05

Reference
S Adeothy-Koumakpai and others. A Survey Confirms the Potency of Nevirapine in Preventing HIV Transmission from Mother to Child in Non Immunosuppressed Women [article in French]. Archives of Pediatrics 11(12): 1425-1429. December 2004.