Mother-to-child transmission of human immunodeficiency virus (HIV) among HIV-infected pregnant women on highly active anti-retroviral therapy with premature rupture of membranes at term

Abstract

Purpose: To determine mother-to-child transmission (MTCT) rate and associated risk factors of human immune-deficiency virus (HIV) among HIV-infected pregnant women with term premature rupture of membranes (PROM) in comparison with those without PROM at term.

Materials and methods: All optimally managed HIV-positive pregnant women of Nnamdi Azikiwe University Teaching Hospital, on highly active anti-retroviral therapy (HAART) who had PROM at term were enrolled. Maternal HIV-1 viral load was not assessed. Follow up was for a minimum of 18 months for evidence of HIV infection.

Results: Of the 121 women with PROM at term, 46 (38.0%) were HIV sero-positive, 22/46 (47.8%) of which had their babies followed up till 18 months. The mean latency period was 10.5 ± 5.3 h in PROM group. Apart from duration of PROM (OR = 0.01; 95%CI = 0.00–0.13; p < 0.001), there were no differences in risk factors seen between cases and controls (p > 0.05). Of the 22 (47.8%) babies followed-up in the PROM group and 13 in non-PROM group, none tested positive to HIV, given an MTCT rate of 0%.

Conclusions: MTCT rate was 0% following term PROM and in women without PROM. Since maternal HIV-1 viral load was not assessed, we need to be critical while interpreting the findings.

Keywords:

• PROM
• HAART
• MTCT of HIV
• rupture of membranes

Acknowledgements

The authors appreciate the help of Institute of Human Virology of Nigeria scientists in Nnewi for helping in the PCR test on the children. We also appreciate the entire staff of neonatology unit/Pediatrics and Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi. We would like to acknowledge the efforts of all the obstetrics care providers (nurse, midwives and doctors) who participated in the management of women in this study.

Disclosure statement

The authors report no conflicts of interest.