Timely antiretroviral prophylaxis during pregnancy effectively reduces HIV mother-to-child transmission in eight counties in China: a prospective study during 2004-2011

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Wang, Q; Wang, L; Fang, L; Wang, A; Jin, X; Wang, F; Wang, X; Qiao, Y; Sullivan, SG; Rutherford, S; ...Date
2016-10-10Source Title
Scientific ReportsPublisher
NATURE PUBLISHING GROUPUniversity of Melbourne Author/s
Sullivan, SheenaAffiliation
Doherty InstituteMetadata
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Wang, Q., Wang, L., Fang, L., Wang, A., Jin, X., Wang, F., Wang, X., Qiao, Y., Sullivan, S. G., Rutherford, S. & Zhang, L. (2016). Timely antiretroviral prophylaxis during pregnancy effectively reduces HIV mother-to-child transmission in eight counties in China: a prospective study during 2004-2011. SCIENTIFIC REPORTS, 6 (1), https://doi.org/10.1038/srep34526.Access Status
Open AccessAbstract
This study investigates the improvement of the prevention of mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) in China during 2004-2011. A clinic-based prospective study was conducted among HIV-positive pregnant women and their children in eight counties across China. Associated factors of mother-to-child transmission were analyzed using regression analysis. A total of 1,387 HIV+ pregnant women and 1,377 HIV-exposed infants were enrolled. The proportion of pregnant women who received HIV testing increased significantly from 45.1% to 98.9% during 2004-2011. Among whom, the proportion that received antiretroviral (ARV) prophylaxis increased from 61% to 96%, and the corresponding coverage in children increased from 85% to 97% during the same period. In contrast, single-dose nevirapine treatment during delivery declined substantially from 97.9% to 12.7%. Vertical transmission of HIV declined from 11.1% (95% confidence interval [CI]: 5.7-23.3%) in 2004 to 1.2% (95% CI: 0.1-5.8%) in 2011. Women who had a vaginal delivery (compared to emergency caesarian section (odds ratio [OR] = 0.46; 0.23-0.96)) and mothers on multi-ARVs (OR = 0.11; 0.04-0.29) were less likely to transmit HIV to their newborns. Increasing HIV screening enabled timely HIV care and prophylaxis to reduce vertical transmission of HIV. Early and consistent treatment with multi-ARVs during pregnancy is vital for PMTCT.
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