Utilization of therapeutic intervention to prevent mother to child transmission of HIV in a teaching hospital in Kolkata, India

• Published in: The journal of obstetrics and gynaecology research Vol. 36; no. 3; pp. 619 - 625
• Main Authors: Chaudhuri, Snehamay, Mundle, Malay, Konar, Hiralal, Das, Chandana, Talukdar, Arunansu, Ghosh, Uday Sankar
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.06.2010
• Subjects: Cross-Sectional Studies; Female; HIV; HIV Infections - drug therapy; HIV Infections - prevention & control; HIV Infections - transmission; HIV Seropositivity - drug therapy; HIV Seropositivity - transmission; Hospitals, Teaching; Humans; India; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Mass Screening; mother to child transmission; MTCT; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - drug therapy; Prenatal Care; Retrospective Studies; therapeutic intervention; India
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/j.1447-0756.2009.01161.x

Aim:  To assess the uptake of an HIV screening program and therapeutic intervention to minimize the risk of mother to child transmission. Methods:  This was a cross‐sectional, observational study with retrospective data obtained from patient medical records. Pregnant women presenting to a tertiary care center in Kolkata, India, from 1 January 2004 – 31 December 2007 underwent HIV serology by rapid test after receiving group counseling. Care was administered using a standard national protocol by a multi‐disciplinary team of health‐care personnel. Main outcome measures were: acceptance of pretest counseling and HIV testing by pregnant women attending antenatal clinic services, post‐test counseling rate, coverage rate of nevirapine to mother–child pairs, and averted HIV infection in children. Results:  Of the 52 127 new antenatal booking visits, 49 580 (95.11%) women attended pretest counseling and 47 506 (91.13%) women accepted HIV testing. Eighty‐six women were found to be seropositive. The seroprevalence rate of HIV infection was 0.17%. Thirty‐seven mothers (88%) and all newborn infants (100%) had received nevirapine prophylaxis. Overall nevirapine coverage rate was 48%. Twenty‐four of the mother–infant pairs that we assessed had infants who were aged over 18 months by June 2008. Eleven (45.83%) of these women turned up with their babies for a blood test at 18 months. Three (27.27%) babies tested reactive. Conclusion:  As uptake of testing is high and detection of HIV‐infected women in pregnancy remains very low, a radical rethinking of policies on therapeutic intervention and their implementation now needs to be undertaken.