Maternal retention and early infant HIV diagnosis in a prospective cohort study of HIV-positive women and their children in Malawi

Abstract

Background Post-partum loss to follow-up and lack of early HIV infant diagnosis (EID) can significantly affect the efficiency of programs for the prevention of mother-to-child transmission. Methods In a prospective observational study 167 women were enrolled at week 36 of gestation and followed with their infants up to one year after delivery. Retention was defined as the proportion of women who attended the 12 months visit and EID as an HIV PCR test performed within 2 months. Determinants for retention and EID were assessed in univariate analyses and in multivariable logistic regression models. Results Women lost to follow-up (24/167 or 14.4%) had a shorter duration of antiretroviral therapy (ART) at enrolment in comparison to women retained in care ( p = 0.025). Lack of EID (occurring in 18.9% of the cases) was directly correlated, although not significantly, with a history of child death ( p = 0.071), a higher educational level ( p = 0.083), and female infant gender ( p = 0.064). Conclusions Longer duration of ART at enrolment significantly predicted a better post-partum retention, suggesting that specific counselling interventions should be targeted to recent ART initiators. A low proportion of infants did not receive an EID, but predictive factors were difficult to identify.

Insufficient measles antibody protection in 6‐month‐old Malawian infants: Reconsider vaccination schedule?

“…The present analysis is part of a larger study aiming to investigate the impact of maternal HIV infection and antiretroviral therapy (ART) on exposed infants under Option B+ (universal life-long ART for all HIV-positive women, independently of their disease stage) and assess the factors influencing maternal retention in care [20,21]. Mothers living with HIV and HIV-negative mothers with their infants were enrolled between 32 and 36 weeks of gestation.…”

Rates of Seroprotection against Vaccine-Preventable Infectious Diseases in HIV-Exposed and -Unexposed Malawian Infants

“…The present analysis is part of a study conducted between January 2019 and June 2021 that aimed to assess the factors that determine maternal retention in programs for the prevention of vertical HIV transmission and to compare the health of HIV-exposed infants under Option B+ with that of a parallel cohort of HIV-unexposed infants [ 17 ]. The assessment of infant health included the evaluation of growth parameters, the determination of the immune responses to vaccine-preventable diseases (i.e., the aim of the present report), and the incidence of infectious and non-infectious events [ 18 ].…”