Prevalence of HIV in Pregnant Women and Rate of Vertical Transmission A Retrospective Study

Abstract

Background: HIV transmission from mother to child during pregnancy, labor, delivery, or breastfeeding is called perinatal transmission. Highly active antiretroviral therapy (HAART) for HIV-positive pregnant women reduces the risk of mother to child transmission of infection. Objective: The objective of present study is to know the prevalence of HIV infection in patients delivered in this tertiary care hospital (routine as well as emergency case) and to find out the vertical transmission rate in these patients. Methods: This retrospective study was carried out in all antenatal patients delivered in Dr RPGMC, Tanda at Kangra, April, 2014 –July, 2016. Results: The prevalence of HIV with pregnancy come out,0.7/1000/year. 50% of patients were from the age group of 26 to 30 years with mean age of patient was 27years. 71.42% of patients had sexual mode of transmission. 64.28% were nulliparous. Only 21.42% of HIV positive patients took antenatal visit in the first trimester and started HAART, but majority of the patients, 42.85% reported in 3rd trimester. Lowest reported CD4 count was 75, among 14 patients, 50% of patients had CD4 count > 350 at the time of reporting and initiating HAART. Out of 14 patients 11 had normal vaginal delivery whereas 3 had undergone LSCS. Out of 11 vaginally delivered patients 1 neonate expired within 1 week after birth, rest 90.9% neonates are HIV negative till date. Out of 3patients who had undergone LSCS 100% are HIV negative till date. Out of 14 none of the infants were breastfed and Nevaripine prophylaxis given to all neonates. Neonates were followed at 6month and 18 month for HIV testing, all were negative till date. Conclusion: Early universal screening of all pregnant women and early use of Highly Active Anti-retroviral therapy in HIV infected patients, safe labor practices; timely done caesarean section, avoiding breast feeding and Nevirapine prophylaxis to neonate can decrease the rate of perinatal transmission of HIV infection.