Prevention of Mother-to-Child Transmission of HIV: Data Analysis Based on Pregnant Women Population from 2012 to 2018, in Nantong City, China

Page: [458 - 465] Pages: 8

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Abstract

Background: China has implemented a nation-wide policy to control mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) since 2011, yet the efficacy of the control policy is less studied. The aim of the present study was to report the data in the prevention of MTCT of HIV in Nantong city, China.

Methods: The screening and prevalence of HIV in pregnant women and the efficacy of prophylaxis in Nantong city, China, January 2012 through December 2018, were analyzed.

Results: Among a total population of 410,044 pregnant women, anti-HIV was tested prenatally in 393,658 (96.0%) women and in 16,287 (3.97%) women at delivery. In total, 51 women were confirmed with HIV infection. After the exclusion of repeat pregnancies, the overall prevalence of HIV infection was 1.20/10 000 (48/400,377). The prevalence (6.75/10,000) in women tested at delivery was >5-fold higher than that (1.02/10,000) in prenatally screened women. Of 48 HIV-infected women, 12 terminated their pregnancies and 36 others delivered 36 neonates, of whom 35 were followed up. No HIV infection occurred in 24 children born to mothers with antiretroviral therapy (ART) during pregnancy along with other preventive measures. Among 11 children born to mothers who did not receive ART during pregnancy because of the absence of a prenatal anti-HIV test, none of the 6 children who were delivered by cesarean section and timely administered neonatal antiretroviral prophylaxis was infected, but 2 (40%) of 5 children who were spontaneously delivered and administered delayed antiretroviral prophylaxis were infected.

Conclusion: Prenatal identification of HIV infection and timely administration of all preventive measures can completely block MTCT of HIV. The data indicate that more efforts must be taken to ensure that all pregnant women are tested for anti-HIV during pregnancy. For pregnant women who missed the prenatal screening, a positive result in rapid anti-HIV test at delivery should be sufficient to take preventive measures to prevent MTCT of HIV.

Keywords: HIV, pregnant women, prenatal screening, prevalence, mother-to-child transmission, antiretroviral therapy, prophylaxis.

Graphical Abstract

[1]
UNAIDS. Global HIV/AIDS overview/HIVgovThe Global HIV/AIDS Epidemic 2019.https://www.hiv.gov/federal-response/pepfar-global-aids/global-hiv-aids-overview
[2]
World Health Organization. Prevention of mother-to-child transmission Estimates by WHO region https://apps.who.int/gho/data/view.main.23500REG?lang=en
[3]
Shetty AK. Epidemiology of HIV infection in women and children: a global perspective. Curr HIV Res 2013; 11(2): 81-92.
[http://dx.doi.org/10.2174/1570162X11311020002] [PMID: 23432485]
[4]
Moretton MA, Bertera F, Lagomarsino E, Riedel J, Chiappetta DA, Höcht C. Advances in therapy for the prevention of HIV transmission from mother to child. Expert Opin Pharmacother 2017; 18(7): 657-66.
[http://dx.doi.org/10.1080/14656566.2017.1316369] [PMID: 28398096]
[5]
De Cock KM, Fowler MG, Mercier E, et al. Prevention of mother- to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 2000; 283(9): 1175-82.
[http://dx.doi.org/10.1001/jama.283.9.1175] [PMID: 10703780]
[6]
Mphatswe W, Blanckenberg N, Tudor-Williams G, et al. High frequency of rapid immunological progression in African infants infected in the era of perinatal HIV prophylaxis. AIDS 2007; 21(10): 1253-61.
[http://dx.doi.org/10.1097/QAD.0b013e3281a3bec2] [PMID: 17545701]
[7]
Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1994; 331(18): 1173-80.
[http://dx.doi.org/10.1056/NEJM199411033311801] [PMID: 7935654]
[8]
Shaffer N, Chuachoowong R, Mock PA, et al. Bangkok Collaborative Perinatal HIV Transmission Study Group. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Lancet 1999; 353(9155): 773-80.
[http://dx.doi.org/10.1016/S0140-6736(98)10411-7] [PMID: 10459957]
[9]
Prendergast A, Mphatswe W, Tudor-Williams G, et al. Early virological suppression with three-class antiretroviral therapy in HIV-infected African infants. AIDS 2008; 22(11): 1333-43.
[http://dx.doi.org/10.1097/QAD.0b013e32830437df] [PMID: 18580613]
[10]
Thorne C, Newell ML. Mother-to-child transmission of HIV infection and its prevention. Curr HIV Res 2003; 1(4): 447-62.
[http://dx.doi.org/10.2174/1570162033485140] [PMID: 15049430]
[11]
World Health Organization. PMTCT strategic vision 2010–2015: preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals: moving towards the elimination of pediatric HIV 2010.https://apps.who.int/iris/bitstream/handle/10665/44268/9789241599030_eng.pdf?sequence=1&isAllowed=y
[12]
Selph SS, Bougatsos C, Dana T, Grusing S, Chou R. Screening for HIV infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2019; 321(23): 2349-60.
[http://dx.doi.org/10.1001/jama.2019.2593] [PMID: 31184704]
[13]
UNAIDS. Towards an AIDS-free world for children; a global push to end pediatric AIDS http://usa.fxb.org/wp-content/uploads/ Towards-an-AIDS-Free-Worldfor-Children-A-Global-Push-to- End
[14]
Jiang JR, Zhou YB, Li HT, et al. [HIV epidemic among pregnant women in China, 2016: trend and spatial analysis]. Zhonghua Yi Xue Za Zhi 2018; 98(41): 3360-4. [Chinese].
[PMID: 30440129]
[15]
Wu S, Gao M, Zheng J, et al. Prevalence of HIV indeterminate Western blot tests and follow-up of HIV antibody seroconversion in Southeastern China. Virol Sin 2019; 34(4): 358-66.
[http://dx.doi.org/10.1007/s12250-019-00130-3] [PMID: 31190120]
[16]
Wang AL, Qiao YP, Wang LH, et al. Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China. Bull World Health Organ 2015; 93(1): 52-6.
[http://dx.doi.org/10.2471/BLT.14.139626] [PMID: 25558108]
[17]
Zhang XH, Lu W, Wu QY, Jiang JY, Chen DQ, Qiu LQ. Progress in prevention of mother-to-child transmission of HIV-1 in Zhejiang province, China, 2007-2013. Curr HIV Res 2013; 11(8): 652-7.
[http://dx.doi.org/10.2174/1570162X12666140226102402] [PMID: 24568641]
[18]
Zhao J, Chen Q, Fu C, et al. Rate of the HIV transmission and associated factors among HIV-exposed infants in Guangxi, China: 2014-2019. AIDS Res Hum Retroviruses 2020; 36(8):647-55.
[http://dx.doi.org/10.1089/AID.2020.0073] [PMID: 32498619]
[19]
von Linstow ML, Rosenfeldt V, Lebech AM, et al. Prevention of mother-to-child transmission of HIV in Denmark, 1994-2008. HIV Med 2010; 11(7): 448-56.
[http://dx.doi.org/10.1111/j.1468-1293.2009.00811.x] [PMID: 20146735]
[20]
National Health Committee of China. Protocol for prevention of mother-to-child transmission of HIV, syphilis and Hepatitis B [Chinese] Beijing, China: Ministry of Health of China 2011.http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=1957feaad9524cdd89c3bf68ab086fb7
[21]
Gong T, Wang H, He X, Liu J, Wu Q, Wang J. Investigation of prevention of mother to child HIV transmission program from 2011 to 2017 in Suzhou, China. Sci Rep 2018; 8(1): 18071.
[http://dx.doi.org/10.1038/s41598-018-36623-6] [PMID: 30584264]
[22]
World Health Organization. Elimination of mother-to-child transmission (EMTCT) of HIV and syphilis Global guidance on criteria and processes for validation Geneva, Switzerland: World Health Organization 2014.http://www.who.int/hiv/pub/emtct- validation-guidance/en/
[23]
Kishamawe C, Vissers DC, Urassa M, et al. Mobility and HIV in Tanzanian couples: both mobile persons and their partners show increased risk. AIDS 2006; 20(4): 601-8.
[http://dx.doi.org/10.1097/01.aids.0000210615.83330.b2] [PMID: 16470125]
[24]
McGrath N, Eaton JW, Newell ML, Hosegood V. Migration, sexual behaviour, and HIV risk: a general population cohort in rural South Africa. Lancet HIV 2015; 2(6): e252-9.
[http://dx.doi.org/10.1016/S2352-3018(15)00045-4] [PMID: 26280016]
[25]
Edwards JK, Arimi P, Ssengooba F, et al. The HIV care continuum among resident and non-resident populations found in venues in East Africa cross-border areas. J Int AIDS Soc 2019; 22(1)e25226
[http://dx.doi.org/10.1002/jia2.25226] [PMID: 30675984]
[26]
Yang S, Yang C, Liao Q, et al. Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015. PLoS One 2017; 12(9)e0183418
[http://dx.doi.org/10.1371/journal.pone.0183418] [PMID: 28880917]
[27]
Chen H, Wu X, Chen L, et al. Rapidly spreading human immunodeficiency virus epidemic among older males and associated factors: a large-scale prospective cohort study in rural southwest China. Sex Transm Dis 2019; 46(4): 234-9.
[http://dx.doi.org/10.1097/OLQ.0000000000000957] [PMID: 30870324]
[28]
Liu B, Shi D, Wang W, et al. What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis. BMJ Open 2019; 9(8)e023699
[http://dx.doi.org/10.1136/bmjopen-2018-023699] [PMID: 31420377]
[29]
Huang KY, Li YP, Shih CC, et al. Mother-to-child transmission of HIV: An 11-year experience in a single center and HIV prevention effectiveness in Taiwan. J Formos Med Assoc 2019; 118(8): 1211-7.
[http://dx.doi.org/10.1016/j.jfma.2019.05.001] [PMID: 31113749]