International AIDS Society

HIV-Free Survival 92% at 2 Y in Rwandan Infants of HIV+ Mothers

Author: Mark Mascolini

03 March 2012

More than 90% of children born to HIV-positive mothers in Rwanda survive without HIV infection through 9 to 24 months, according to results of a representative household survey conducted between February and May 2009.

Being a member of an association of people living with HIV independently improved HIV-free survival by 30%.

The survey involved mothers who attended an antenatal care center at least once during their most recent pregnancy and had a child between 9 and 24 months old. Researchers used two-stage cluster sampling to select mother-infant pairs. They interviewed mothers during household visits and tested children for HIV.

Of the 1446 HIV-exposed children of surveyed mothers, 44 (3%) had died by 9 months of age. Among 1340 live children, 53 (4%) tested positive for HIV to yield a 9- to 24-month HIV-free survival rate of 91.9% (95% confidence interval [CI] 90.4% to 93.3%).

Survival chances were 40% higher in children of mothers taking combination antiretroviral therapy, but that association fell short of statistical significance (adjusted odds ratio 0.6, 95% CI 0.3 to 1.07).

Being a member of an association of people living with HIV independently improved child survival chances 30% (adjusted odds ratio 0.7, 95% CI 0.1 to 0.995).

The investigators believe the national program to prevent vertical HIV transmission “could achieve greater impact on child survival by ensuring access to [combination antiretroviral therapy] for all HIV-positive pregnant women in need, improving the quality of the programme in rural areas, and strengthening linkages with community-based support systems, including associations of people living with HIV.”

The researchers add that “measuring the effectiveness of the national [vertical transmission] programme is imperative to determining the best course of action at the country level, and to making better use of the limited financial resources available.”

Source: Hinda Ruton, Placidie Mugwaneza, Nadine Shema, Alexandre Lyambabaje, Jean de Dieu Bizimana, Landry Tsague, Elevanie Nyankesha, Claire M. Wagner, Vincent Mutabazi, Jean Pierre Nyemazi, Sabin Nsanzimana, Corine Karema, Agnes Binagwaho. HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey. Journal of the International AIDS Society. 2012; 15: 4.

Complete article provided by JIAS, an open-access journal