A Study on Maternal Viral Load, CD4 Cell Counts and Time of Mother-to-Child Transmission of HIV-1 in Two Hospitals in Central Ethiopia


Background: Vertical transmission of HIV among women who have no access to ART is estimated to be 25% - 35% in Africa. Objective: The aim of the study was to assess the time of MTCT of HIV-1 the efficacy of ART on prevention of mother-to-child transmission (MTCT) of HIV-1 in two hospitals. Methods: Prospective cohort study was conducted from November 2011 to May 2012. A total of 162 participants, 81 mothers (24 non-breastfeeding and 57 breastfeeding) and 81 infants were involved in the study. Venous blood from mothers and heel blood (dried blood spot) from infants were collected and processed in Adama Regional laboratory. All dried blood spot specimens of infants reactive on ELISA test were assessed by DNA-based polymerase chain reaction tests (DNA PCR) to determine HIV infection. Data were entered and analysed using SPSS version 19 computer software. Results: Five infants were infected with HIV at the end of this study. The overall rate of vertical transmission of HIV was 6.2%. Maternal viral load at delivery was independently associated with both in-utero and intra-partum transmission (OR = 27.0, 95% CI, 3.5 - 210, p = 0.001). Maternal viral load at 6 weeks of birth and low infant birth weight was associated with intra-partum transmission among breastfeeding mothers (OR = 25.5, 95% CI, 1.14 - 572, p = 0.04) and (OR = 29.6, 95% CI, 3.2 - 273, p = 0.004), respectively. There were 40% MTCT of HIV among non ARV drug users and only 3.9% among those used ARV drugs during their current pregnancy. Conclusion: Strategies planned to reduce maternal viral load during pregnancy can be successful in substantially reducing vertical transmission of HIV. In addition, other contributing factors for MTCT of HIV-1 should be controlled.

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Gonfa, M. and Gebre-Selassie, S. (2014) A Study on Maternal Viral Load, CD4 Cell Counts and Time of Mother-to-Child Transmission of HIV-1 in Two Hospitals in Central Ethiopia. Open Access Library Journal, 1, 1-12. doi: 10.4236/oalib.1100619.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] De Cock, K.M., Fowler, M.G., Mercier, E., et al. (2000) Prevention of Mother-to-Child HIV Transmission in Resource-Poor Countries: Translating Research into Policy and Practice. JAMA, 283, 1175-1182.
[2] Mullick, S., Watson-Jones, D., Beksinska, M. and Mabey, D. (2005) Sexually Transmitted Infections in Pregnancy: Prevalence, Impact on Pregnancy Outcomes, and Approach to Treatment in Developing Countries. Sexually Transmitted Infections, 81, 294-302.
[3] UNAIDS (2010) Report on the Global AIDS Epidemic. UNAIDS, Geneva.
[4] WHO (2010) Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants. Recommendations for a Public Health Approach (2010 Version). WHO, Geneva.
[5] Tubiana, R., Chenadec, J.L., Rouzioux, C., Mandelbrot, L., Hamrene, K., Dollfus, C., et al. (2010) Factors Associated with Mother-to-Child Transmission of HIV-1 Despite a Maternal Viral Load 500 Copies/mL at Delivery: A Case-Control Study Nested in the French Perinatal Cohort (EPF-ANRS CO1). Clinical Infectious Diseases, 50, 585-596.
[6] Mofenson, L.M. (2002) US Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United States. MMWR—Recommendations and Reports, 51, 1-38.
[7] Chinnock, P., Siegfried, N. and Clarke, M. (2005) Is Evidence-Based Medicine Relevant to the Developing World. PLOS Medicine, 2, Article ID: e277.
[8] Okonji, J.A., Zeh, C., Weidle, P.J., Williamsin, J., Akott, B., Masaba, R., et al. (2012) CD4, Viral Load Response and Adherence among Antiretroviral-Naive Breastfeeding Women Receiving Triple Antiretroviral Prophylaxis for Prevention of Mother-to-Child Transmission of HIV in Kisumu, Kenya. Journal of Acquired Immune Deficiency Syndromes, 61, 249-257.
[9] Charurat, M., Datong, P., Matawal, B., Ajene, A., Blattner, W. and Abimiku, A. (2009) Timing and Determinants of Mother-to-Child Transmission of HIV in Nigeria. International Journal of Gynecology Obstetrics, 106, 8-13.
[10] Jamieson, D.J., Sibailly, T.S., Sadek, R., Roels, T.H., Ekpini, E.R., Boni-Ouattara, E., et al. (2003) HIV-1 Viral Load and Other Risk Factors for Mother-to-Child Transmission of HIV-1 in a Breast-Feeding Population in Cote d’Ivoire. Journal of Acquired Immune Deficiency Syndromes, 34, 430-436.
[11] Duri, K., Gumbo, F.Z., Kristiansen, K.I., Kurewa, N.E., Mapingure, M.P., Rusakaniko, S., et al. (2010) Antenatal HIV-1 RNA Load and Timing of Mother to Child Transmission; A Nested Case-Control Study in a Resource Poor Setting. Virology Journal, 7, 176.
[12] Gupta, A., Gupte, N., Sastry, J., Bharucha, K.E., Bhosale, R., Kulkarni, P., et al. (2007) Mother-to-Child Transmission of HIV among Women Who Chose Not to Exclusively Breastfeed Their Infants in Pune, India. Indian Journal of Medical Research, 126, 131-134
[13] Delicio, A.M., Milanez, H., Amaral, E., Morais, S.S., Lajos, G.J., Silva, J., et al. (2011) Mother-to-Child Transmission of Human Immunodeficiency Virus in a Ten Years Period. Reproductive Health, 8, 35.
[14] Brahmbhatta, H., Kigozib, G., Serwaddac, D., Wabwire-Mangend, F., Sewankamboe, N., Wawera, M., et al. (2009) Is the Risk of Mother-to-Child Transmission of HIV Higher among Female Compared with Male Infants? A Case of Rakai, Uganda. The Pediatric Infectious Disease Journal, 4, 275-279.
[15] Ayouba, A., Nerrienet, E., Menu, E., Lobé, M.M., Thonnon, J., Leke, R.J., et al. (2003) Mother-to-Child Transmission of Human Immunodeficiency Virus Type 1 in Relation to the Season in Yaoundé, Cameroon. The American Journal of Tropical Medicine and Hygiene, 69, 447-449.
[16] Mock, P.A., Shaffer, N., Bhadrakom, P., Siriwasin, W., Chotpitayasunondhi, T., Chearskul, S., et al. (1999) Maternal Viral Load and Timing of Mother-to-Child HIV Transmission, Bangkok, Thailand. Bangkok Collaborative Perinatal HIV Transmission Study Group. AIDS, 13, 407-414.
[17] Townsend, C.L., Cortina-Borja, M., Peckham, C.S., de, R.A., Lyall, H. and Tookey, P.A. (2008) Low Rates of Mother-to-Child Transmission of HIV Following Effective Pregnancy Interventions in the United Kingdom and Ireland, 2000-2006. AIDS, 22, 973-981.
[18] Cooper, E.R., Charurat, M., Mofenson, L., Piatt, J., Diaz, C., Hayani, K., et al. (2002) Women and Infants’ Transmission Study Group: Combination Antiretroviral Strategies for the Treatment of Pregnant HIV-1-Infected Women and Prevention of Perinatal HIV-1 Transmission. Journal of Acquired Immune Deficiency Syndromes, 29, 484-494.
[19] Fowler, M.G., Mofenson, L., McConnell, M., et al. (2003) The Interface of Perinatal HIV Prevention, Antiretroviral Drug Resistance, and Antiretroviral Treatment: What Do We Really Know? Journal of Acquired Immune Deficiency Syndromes, 34, 308-311.
[20] Abrams, E.J. (2004) Prevention of Mother to Child Transmission of HIV Successes, Controversies and Critical Questions. Aids Reviews, 6, 131-143.
[21] Bedri, A., Gudetta, B., Isehak, A., Kumbi, S., Lulseged, S., Mengistu, Y., et al. (2008) Extended-Dose Nevirapine to 6 Weeks of Age for Infants to Prevent HIV Transmission via Breastfeeding in Ethiopia, India, and Uganda: An Analysis of Three Randomized Controlled Trials. Lancet, 372, 300-313.
[22] Piwoz, E.G., Humphrey, J.H., Tavengwa, N.V., Iliff, P.J., Marinda, E.T., Zunguza, C.D., et al. (2007) The Impact of Safer Breastfeeding Practices on Postnatal HIV-1 Transmission in Zimbabwe. American Journal of Public Health, 97, 1249-1254.

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