The impact of Option B+ on mother‐to‐child transmission of HIV in Africa: A systematic review

Abstract

In 2015, the WHO released new guidelines to reduce mother-to-child transmission (MTCT) of HIV. The recommendations, known as Option B+, included initiation of lifelong highly active antiretroviral therapy regardless of CD4 count for all HIV-positive pregnant and breastfeeding mothers. For infants, exclusive breastfeeding for 6 months and antiviral therapy were sanctioned. Targets of <5% transmission in breastfeeding populations and <2% in non-breastfeeding populations were set. This review evaluated the impact of Option B+ on MTCT in African countries. Methods: Using the PRISMA guidelines, a systematic search of PubMed and Google Scholar databases was conducted to identify relevant studies published between 2015 and 2021. All studies meeting inclusion criteria were evaluated. Results: Of the 687 references screened, 22 studies from 11 countries (Cameroon,

Partner-based HIV treatment for seroconcordant couples attending antenatal and postnatal care in rural Mozambique: A cluster randomized controlled trial

“…In countries of Africa with a high HIV prevalence, everyone with HIV, including pregnant women, receives free life-long combination antiretroviral therapy (ART). [1][2][3][4] However, retention in care throughout pregnancy and the postpartum period remains suboptimal. [5][6][7][8][9][10] Poor medication adherence, risk of vertical HIV transmission, and ART resistance hamper the global effort to end the HIV pandemic.…”

Reduced anti-viral IgG repertoire in HIV-exposed but uninfected infants compared to HIV-unexposed infants

“…Universal access to antiretroviral treatment (ART) has drastically reduced perinatal transmission of HIV from 25%–40% in the early 2000s to a global rate of less than 7% in the option B+ era. 1 , 2 However, the prevalence of HIV among women of childbearing age remains high, resulting in an increasing population of iHEU. 2 Sub-Saharan Africa carries the highest number of these infants, having an estimated population of 13.2 million children born to women living with HIV.…”