Academic
Publications
Progress in prevention of mother-to-child transmission of HIV infection in Ukraine: results from a birth cohort study

Progress in prevention of mother-to-child transmission of HIV infection in Ukraine: results from a birth cohort study,10.1186/1471-2334-9-40,BMC Infec

Progress in prevention of mother-to-child transmission of HIV infection in Ukraine: results from a birth cohort study   (Citations: 4)
BibTex | RIS | RefWorks Download
BACKGROUND: Ukraine was the epicentre of the HIV epidemic in Eastern Europe, which has the most rapidly accelerating HIV epidemic world-wide today; national HIV prevalence is currently estimated at 1.6%. Our objective was to evaluate the uptake and effectiveness of interventions for prevention of mother-to-child transmission (PMTCT) over an eight year period within operational settings in Ukraine, within the context of an ongoing birth cohort study. METHODS: The European Collaborative Study (ECS) is an ongoing birth cohort study in which HIV-infected pregnant women identified before or during pregnancy or at delivery were enrolled and their infants prospectively followed. Three centres in Ukraine started enrolling in 2000, with a further three joining in September 2006. RESULTS: Of the 3356 women enrolled, 21% (689) reported current or past injecting drug use (IDU). Most women were diagnosed antenatally and of those, the proportion diagnosed in the first/second trimester increased from 47% in 2000/01 (83/178) to 73% (776/1060) in 2006/07 (p < 0.001); intrapartum diagnosis was associated with IDU (Adjusted odds ratio 4.38; 95%CI 3.19–6.02). The percentage of women not receiving any antiretroviral prophylaxis declined from 18% (36/205) in 2001 to 7% in 2007 (61/843) (p < 0.001). Use of sdNVP alone substantially declined after 2003, with a concomitant increase in zidovudine prophylaxis. Median antenatal zidovudine prophylaxis duration increased from 24 to 72 days between 2000 and 2007. Elective caesarean section (CS) rates were relatively stable over time and 34% overall. Mother-to-child transmission (MTCT) rates decreased from 15.2% in 2001 (95%CI 10.2–21.4) to 7.0% in 2006 (95%CI 2.6–14.6). In adjusted analysis, MTCT risk was reduced by 43% with elective CS versus vaginal delivery and by 75% with zidovudine versus no prophylaxis. CONCLUSION: There have been substantial improvements in use of PMTCT interventions in Ukraine, including earlier diagnosis of HIV-infected pregnant women and increasing coverage with antiretroviral prophylaxis and the initial MTCT rate has more than halved. Future research should focus on hard-to-reach populations such as IDU and on missed opportunities for further reducing the MTCT rate.
Journal: BMC Infectious Diseases - BMC INFECT DIS , vol. 9, no. 1, pp. 40-10, 2009
Cumulative Annual
View Publication
The following links allow you to view full publications. These links are maintained by other sources not affiliated with Microsoft Academic Search.
    • ...The introduction of ARV therapy in HIV+ pregnant women has drastically decreased vertical transmission of HIV [1-7]...

    Eliane Borges-Almeidaet al. The impact of maternal HIV infection on cord blood lymphocyte subsets ...

    • ...The initial driver of the epidemic in Ukraine was injecting drug use (IDU), but heterosexual transmission is becoming more important, with increasing prevalence among women and those with no known risk factors for HIV acquisition (history of IDU, high-risk sexual behaviour, high-risk sexual partner(s) or blood transfusion; European Collaborative Study, 2006; Thorne et al, 2009; WHO, UNICEF, & UNAIDS, 2008)...

    Heather Baileyet al. Factors associated with abandonment of infants born to HIV-positive wo...

    • ...This programme has been successful with MTCT rates declining from above 25% in 2001 to 7% in 2006 [1,4]...
    • ...Implementation of comprehensive PMTCT programmes may reduce risk of infant abandonment [2,4,40], and declining rates of abandonment have been documented concurrent with scale-up of PMTCT [40]...
    • ...Unsurprisingly, PMTCT prophylaxis coverage among the mother-child pairs in this sub-cohort of infected children was lower than that seen for the whole cohort, which had 93% coverage in 2006 [4]; however, many of the children here were infected despite receipt of PMTCT prophylaxis, largely sdNVP or short-course ZDV, which are less effective than HAART...
    • ...One-third of mothers here reported an IDU history, higher than that seen in the ECS overall (around a fifth), reflecting the increased risk of intrapartum diagnosis and thus of MTCT among IDUs [4]...

    Saboura Mahdaviet al. Treatment and disease progression in a birth cohort of vertically HIV1...

Sort by: