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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The contribution of maternal HIV seroconversion during late pregnancy and breastfeeding to mother-to-child transmission of HIV
Journal of Acquired Immune Deficiency Syndromes, Volume 59, No. 4, Year 2012
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Description
Background: The prevention of mother-to-child transmission (PMTCT) of HIV has been focused mainly on women who are HIV positive at their first antenatal visit, but there is uncertainty regarding the contribution to overall transmission from mothers who seroconvert after their first antenatal visit and before weaning. Method: A mathematical model was developed to simulate changes in mother-to-child transmission of HIV over time, in South Africa. The model allows for changes in infant feeding practices as infants age, temporal changes in the provision of antiretroviral prophylaxis and counseling on infant feeding, as well as temporal changes in maternal HIV prevalence and incidence. Results: The proportion of mother-to-child transmission (MTCT) from mothers who seroconverted after their first antenatal visit was 26% [95% confidence interval (CI): 22% to 30%] in 2008, or 15,000 of 57,000 infections. It is estimated that by 2014, total MTCT will reduce to 39,000 per annum, and transmission from mothers seroconverting after their first antenatal visit will reduce to 13,000 per annum, accounting for 34% (95% CI: 29% to 39%) of MTCT. If maternal HIV incidence during late pregnancy and breastfeeding were reduced by 50% after 2010, and HIV screening were repeated in late pregnancy and at 6-week immunization visits after 2010, the average annual number of MTCT cases over the 2010-2015 period would reduce by 28% (95% CI: 25% to 31%), from 39,000 to 28,000 per annum. Conclusion: Maternal seroconversion during late pregnancy and breastfeeding contributes significantly to the pediatric HIV burden and needs greater attention in the planning of prevention of MTCT programs. Copyright © 2012 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Johnson, Leigh Francis
South Africa, Cape Town
Faculty of Health Sciences
Stinson, Kathryn
South Africa, Cape Town
Faculty of Health Sciences
Newell, Marie Louise
South Africa, Durban
University of Kwazulu-natal
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Bland, Ruth M.
South Africa, Durban
University of Kwazulu-natal
United Kingdom, Glasgow
University of Glasgow
Moultrie, Harry
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Davies, M. A.
South Africa, Cape Town
Faculty of Health Sciences
Rehle, Thomas M.
South Africa, Cape Town
Faculty of Health Sciences
South Africa, Pretoria
Human Sciences Research Council of South Africa
Dorrington, Rob Edwin
South Africa, Cape Town
University of Cape Town
Sherman, Gayle Gillian
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Statistics
Citations: 156
Authors: 9
Affiliations: 9
Identifiers
Doi:
10.1097/QAI.0b013e3182432f27
ISSN:
15254135
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa
Participants Gender
Female