Survival of HIV Infected Children Born to Mothers Enrolled in a PMTCT Program in a Resource Poor Setting

F. Z. Gumbo, G. Q. Kandawasvika, E. N. Kurewa, K. Duri, P. Chandiwana, M. P. Mapingure, M. Z. Chirenje, B. Stray-Pedersen

Department of Immunology, University of Zimbabwe, Harare, Zimbabwe.
Department of Obstetrics and Gynecology, University of Zimbabwe, Harare, Zimbabwe.
Department of Pediatrics and Child Health, University of Zimbabwe, Harare, Zimbabwe.
Division of Obstetrics and Gynecology, Faculty of Medicine, University of Oslo and Rikshospitalet, Oslo, Norway.
Letten Foundation Research Centre, Harare, Zimbabwe.

DOI: 10.4236/wja.2013.32016                

Abstract

Background: Pediatric HIV is a leading cause of morbidity and mortality worldwide. The substantial expansion in PMTCT has generated information on rates of transmission and associated factors, but there are limited studies on disease progression and mortality in vertically infected children, especially from resource poor settings. Methods: A birth cohort study was initiated in 2002 to focus on the role of a single dose of nevirapine in HIV transmission before Highly Active Antiretroviral Therapy (HAART) was readily available. The enrolment of women and subsequent follow up of the children occurred at 3 peri urban clinics around Harare. Findings: 479 women were HIV infected. From these, 93 (19%) children became HIV infected, 182 (38.0%) uninfected and 204 (43%) lost to follow up before HIV diagnosis. Of the HIV infected children, 40 (43%) died before the fifth birthday, 26 (28%) were lost to follow up and 27 (29%) were alive five years after maternal enrolment prior to availability of cART. Conclusion: In this setting, there was unacceptable high mortality from HIV infected children and loss to follow up prior to availability of HAART. A small proportion of HIV vertically infected children is surviving in resource poor settings without antiretroviral therapy.

Keywords

HIV Infected Children Outcome; Mortality; Loss to Follow Up

Conflicts of Interest

The authors declare no conflicts of interest.

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