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Background: HIV can cause considerable morbidity and mortality in those affected. An effective PPTCT programme helps in reducing the spread of HIV by vertical transmission and improving the life of the women and her baby.Methods: A retrospective study was done at a tertiary care hospital, including pregnant women registered and delivered at the hospital during a period of 9 years from January 2010 to December 2018. Pretest counseling, HIV testing, Post-test counseling were done and antiretroviral prophylaxis given as per the NACP guidelines. Sociodemographic characteristics, obstetric and maternal-foetal outcome of seropositive women and efficacy of PPTCT services were analyzed.Results: Out of the 58,205 antenatal mothers included, 55,256 (94.93%) accepted HIV testing. 171 of these tested positive (0.31%). 70 spouses of the 171 seropositive women tested positive, 53 tested negative and 48 did not undergo the HIV test. Majority of seropositive women were primigravidas; housewives from urban areas, from low income and educational background and with no history of any contraceptive use. 7.6% had an MTP, 1.75% a spontaneous abortion and 0.58% an ectopic pregnancy. Of the 154 births, 35.71% underwent caesarean sections. There were 96.7% live births in our study and the perinatal mortality rate was 5.19%. After 2013, all mother-baby pairs were given ARV prophylaxis.Conclusions: Utilization of PPTCT services has increased through the years, decreasing the vertical transmission and seroprevalence rate. Increasing the acceptance rates of HIV testing, both by patients and partners may further help in curbing the spread of this condition.
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Background: Our study is planned to note the outcome ofpregnancy of the women detected as HIV positive in thePPTCT program as well as to have an evaluation of thePPTCT program in our institute since the initiation of thisprogramme in 2005.Materials & Methods: The present study was carried out inthe department of Obstetrics and Gynaecology, Umaid Hospitalattached to Dr. S. N. Medical College, Jodhpur. The data overthis period were analyzed. As per the strategy and policyprescribed by NACO, tests (E/R/S) were performed on theserum samples. Those found HIV positive went for confidentialpost-test information and counselling regarding throughintimation about the vertical transmission and importance oftheir institutional deliveries.Results: Our study observed that out of the total deliveredbabies of seropositive women 95.31% were live births, 3.90%were IUD babies and one was still birth. Out of the totaldelivered babies 64 i.e. 52.45% had physiological jaundice,35 i.e. 28.68% had acute diarrheal disease, 2 i.e. 1.63% hadoral thrush, 20 i.e. 16.93% had URI, 2 i.e. 1.63% had ServerSepticaemia, 9 babies i.e. 7.37 % expired in neonatal periodand another 9 expired after one month.Conclusion: PPTCT programs are feasible in Governmenthospital were resources are limited. Rural pregnant women arereceptive to voluntary counselling and testing.
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Introduction: Human immunodeficiency virus (HIV) infection israpidly increasing in world as well as in India since thedetection of first acquired immune deficiency syndrome (AIDS)case in Chennai in 1986. Having seroprevalence rate of lessthan 1%, India is considered as low prevalence country but dueto large population this low prevalence convert in a hugesubset of HIV positive people. Unfortunately India shares onethird of total HIV positive cases of the world. Estimating the HIVseroprevalence in a low risk population of pregnant womenprovides vital information for the successful implementation ofAIDS control program and also for monitoring trend of HIV ingeneral population. Therefore, screening of pregnant women inearly pregnancy may help in prompt counselling and therapy,thereby bringing down the mother to child transmission of HIVinfection.Objective: To determine the rate and trends of seroprevalenceof HIV among antenatal women.Materials and Methods: It is a retrospective study conductedat PPTCT centre, Rajendra Institute of Medical Sciences(RIMS), Ranchi, a tertiary care referral hospital in Jharkhandstate of India from January 2014 to December 2016.The testswere done as per NACO guidelines using COMBAIDS-RSAdvantage-ST, HIV-1/2 TRISPOT and MERISCREEN HIV 1-2WB tests.Results: 19266 antenatal women were included in this study.Out of this 57 women were detected to be positive for HIV,accounting for 0.32% prevalence rate. HIV seroprevalenceamongst antenatal women is 0.32% which is in agreement withthe national projection (0.29% as per NACO annual report2014-2015). HIV seroprevalence rates showed a decreasingtrend from 0.32% in 2014 to 0.16% in 2016.Conclusion: Every antenatal woman should be screened forHIV. Appropriate antenatal screening, interventions andpreventive strategies might bring down the mother to childtransmission of HIV.
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Objective: To analyze the outcomes of Prevention of Parent to Child Transmission (PPTCT) of HIV program in an urban Southern Indian setting. Design: Observational study. Setting: Anti-retroviral Therapy (ART) Centers/ Integrated Counseling and Testing Centers (ICTC) at four government Obstetrics Institutes in an urban area. Participants: 100 HIV-positive pregnant women and their infants delivered in the study centers. Methods: Triple drug ART to HIV-positive pregnant women was started for maternal indications only. Rest of the pregnant women were given single dose Nevirapine (200 mg) at the onset of labor. All infants were given single dose Nevirapine (2 mg/kg) prophylaxis, according to National AIDS Control Organization guidelines. Mothers were counseled regarding breastfeeding and artificial feeding, and the choice was left to them. Whole blood HIV 1 DNA PCR was done for all infants at 6 weeks of life. A second PCR was done at 6 months or 6 weeks after stopping breastfeeds. PCR-positive infants were started on ART, and were followed-up till18 months of life. Results: Four infants were PCR-positive for HIV. All of them were breastfed. They were born to mothers of HIV stage 1 or 2 who were not on ART as CD4 counts were >350 cells/mm3. Among the mothers in Stage 3 or 4 or CD4 count <200 cells/mm3 and on ART, none of the infants was HIV-positive. The cumulative HIV-free survival at 18 months was 94%. Conclusion: Parent-to-child transmission rate in HIV was low with the currently used strategies . Triple drug ART to mother reduces mother-to-child transmission despite advanced maternal stage or low CD4 counts.
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Background: Over the years, single dose Nevirapine has been the cornerstone of the PPTCT program in India. However after successful scale up of ART program, initiation of ART for the pregnant was also considered another means of reducing the risk of transmission of HIV. As there were no specific studies to demonstrate the advantages of full-course ART during pregnancy compared to single dose Nevirapine, the current study was undertaken. Objectives: To study the socio-demographic variables, effectiveness of the different interventions and factors affecting the interventions among the PPTCT program beneficiaries. Materials and Methods: As part of the retrospective cohort study the details of the HIV positive pregnant women registered at four ICTCs of Andhra Pradesh were analyzed in two groups (Nevirapine and ART). Results: Total 145 pregnant women were studied and among them, 3.4% opted for MTP, 66.2% had live-birth and 60% had normal vaginal delivery. Upon testing for HIV at 18 months, 35% babies were HIV reactive in the Nevirapine group, 17.6% babies were HIV reactive in the ART group. Interpretation & Conclusion: The findings from the present study showed higher protection among babies with mothers on ART before delivery, compared to those with single dose Nevirapine.
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Background & objectives: Prevention of parent-to-child transmission (PPTCT) services are an integral part of National AIDS Control Programme and their critical appraisal is necessary for improving quality care. The present study was conducted to evaluate the performance of PPTCT services in West Bengal during April, 2008 - March 2009 and April 2009 - March 2010 and identify gaps in service delivery for making suitable recommendations. Methods: Data were collected from the Computerized Management Information System and validated by cross-checking records at each district. Focus group discussions (FGDs) were conducted among programme managers, counsellors and antenatal women attending the Integrated Counselling and Testing Centres. Performance indicators and outcomes of FGDs were analyzed. Results: The proportion of antenatal women tested declined in 2009-2010 from 2008-2009 (64.3 to 63.8%). Proportions of counseled cases also declined (72.5 vs. 68.4%). HIV positivity rates among those tested were 0.13 and 0.14 per cent, respectively in two years. Proportion of mother-baby pairs receiving nevirapine prophylaxis was increased by 5 per cent. Medical colleges, and category A districts having high HIV prevalence provided better services. Follow up services of HIV-exposed birth cohorts were grossly unsatisfactory. Interpretation & conclusions: Gaps were identified at each step of service delivery for which capacity building, improvement of infrastructure including laboratory services and ensuring emergency labour room testing up to the sub-district level were imperative. Outsourcing follow up services to other community based organizations may also be considered.
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Background: The issue of HIV/AIDS and women’s health can be viewed in the context of (1) the unravelling epidemic, (2) the screening of women for HIV and provision of ongoing surveillance, and (3) hope for the future, even though the battle against HIV has not won. Estimating the seroprevalence of HIV in a low risk population such as pregnant women provides essential information for an effective implementation of AIDS control programs, and also for the monitoring of HIV spread within a country. This study was conducted to establish the prevalence rate of HIV amongst pregnant women attending antenatal clinic. Methods: Blood samples from pregnant women attending antenatal clinics in Sola Civil Hospital and G.M.E.R.S. Medical College, Ahmedabad, were collected after informed consent and pre test counselling. The samples were tested for HIV antibodies as per the WHO guidelines. Data was collected and analyzed for a period of 1 year from1st April 2010 to 31st March 2011.Results: Of the 3101 pregnant women tested in one year 11(0.35%) women were found to be HIV seroreactive. Conclusion: The economic and demographic consequences of the spread of HIV/AIDS are inexorable and awesome. The prevalence rate recorded in this study suggests that HIV screening of pregnant women should be an on- going exercise. Development of programs with an integrated approach to inducing behavioural change, promotion of use of condoms and controlling Sexually Transmitted Diseases(STD)’s may reduce the infectivity of HIV transmitters and susceptibility of HIV exposed persons.