AEGiS-13IAC: Acceptability and feasibility of the introduction of a short regimen of oral zidovudine (ZDV) to reduce mother to child transmission (MTCT) of HIV in Rwanda.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Acceptability and feasibility of the introduction of a short regimen of oral zidovudine (ZDV) to reduce mother to child transmission (MTCT) of HIV in Rwanda.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC551)

Karita E, Uwamaliya H, Carmelinda S, Munyangabe C, Mpfizi B, Tekirya E, Rusanganwa E, Shengero S, Van Hove D
E. Karita, Natinal HIV-Reference Laboratory, POBox 4668 Kigali, Kigali, Rwanda, Tel.: +250 784 74, Fax: +250 740 38, E-mail: labhiv@rwandatel1.rwanda1.com

BACKGROUND: In Rwanda about 40.000 infants per year are born to HIV-infected mothers of whom 10.000 may be infected perinataly. This pilot intervention studies the acceptability and feasibility of the routine utilisation of a maternal oral short regimen of ZDV to reduce MTCT in Kicukiru health centre in Rwanda.

METHODS: Kicukiru health centre is situated in the capital Kigali. Antenatal clinic services include: obstetrical history and general physical examination, HIV and syphilis voluntary testing and counselling for those who consent, malaria prophylaxis, iron and folate supplements. Women who had confirmed HIV-1 infection received intensive counselling about prevention of MTCT. Women who accepted the intervention were treated with ZDV: 300 mg twice daily from 36 weeks' gestation until onset of labour, taken once at onset of labour, and then every 3 h until delivery.

RESULTS: From April 1999 until January 2000, 1123 pregnant women attended the antenatal clinic of whom 780 (70%) accepted to be tested for HIV. The overall HIV prevalence was 23%. Eighty-nine percent (161/181) of the HIV infected women returned for their test results. Eighty-nine percent accepted the intervention. The median length of prepartum treatment was 14 days. Seventy percent (67/96) received intrapartum treatment. The average number of intrapartum doses was 3. Eighty-seven percent of the HIV infected women opted to feed their baby with breast milk substitutes.

CONCLUSION: Providing voluntary HIV counselling and testing within antenatal clinic services is the most challenging component of the MTCT intervention. A short regimen of ZDV is well accepted, but because of uncertainty about gestational age or since women present too late in pregnancy to receive full course of ZDV, alternative strategies should be explored. Single dose neverapine could be an alternative.

Keywords: AEGIS, Zidovudine, HIV Infections, HIV Seropositivity, Mothers, Counseling, Prevalence, Rwanda, Child, Infant, Human, Female, Pregnancy, transmission
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