AEGiS-13IAC: Experiences on the use of Zidovudine to prevent mother-to-child transmission of HIV in Kenya.

13th International AIDS Conference

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

Experiences on the use of Zidovudine to prevent mother-to-child transmission of HIV in Kenya.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC552)

Songok EM, Njoroge WJ, Kakimoto K, Makokha EW, Ichimura H, Fujiyama Y, Orege PA, Tukei PM
E.M. Songok, PO Box 54840 Nairobi, Nairobi, Kenya, Tel.: +254 2 722 541, Fax: +254 2 720 030, E-mail: polioke@lconnect.co.ke

The successful use of a short course of zidovudine in lowering vertical transmission of HIV has been reported in several countries. The impact of this regimen on child survival in Kenya has not been established. In an effort to determine its usefulness, we recruited and followed up a cohort of HIV positive pregnant women and their children for a period of two years.

METHOD: Women attending antenatal check-ups in seven health centres in Western Kenya from August to October 1998, were pretest counseled and on consent tested for HIV using simple rapid test (Serodia,) and confirmed by ELISA (Behringwerke,). HIV positive mothers were put on a 400 mg dose of AZT per day beginning at the 36th week and 300 mg every three hours at onset of labor. Clinical evaluation was done on mother and child and samples taken every three months for 18 months.

RESULTS: Out of the 825 mothers screened, 216 (26.2%) were HIV positive. Out of these, 124 (57.4%) received AZT. Out of those that did not take AZT, 61% was due to incorrect calculation of gestation period, 17% had moved out of the study area to join their husbands in urban areas, 11% were refused by their spouses to continue and 7% were lost to follow up. Overall an infant mortality of 266 per 1,000 live births occurred in the HIV positive group as compared to 107 per 1000 live births in the HIV negative group. In the mothers given AZT a child mortality rate of 192 per 1,000 live births was recorded as compared with a mortality rate of 374 per 1000 live births in the non-AZT group (p value > 0.0001).

CONCLUSION: Irrespective of their HIV status, children born to HIV positive mothers in Western Kenya are two times more likely to die before the age of 2. However, a mother's use of zidovudine during pregnancy will double the chances of child survival.

Keywords: AEGIS, Zidovudine, HIV Infections, Disease Transmission, Vertical, HIV Seropositivity, Mothers, Infant Mortality, Kenya, Child, Human, Female, Infant, Pregnancy, transmission, utilization
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