Risk Factors Associated with Mother-to-Child Transmission of HIV-1, Spontaneous Abortion and Infant Mortality in HIV-1 Infected Women in Burkina Faso: A Prospective Study

Background: Despite efforts to fight, HIV/AIDS mother-to-child transmission of HIV-1 (MTCT), as well as abortion and infant mortality, remains a problem in sub-Saharan Africa. Indeed, a low level of CD4 and a high viral load can be associated with these situations. The aim of this study was to determine the risk factors associated with the occurrence of MTCT, spontaneous abortion and infant mortality in HIV-1 infected women in Ouagadougou, Burkina Faso. This was a prospective study conducted from May 2014 to September 2017 and involved 423 HIV-1 infected women followed at Saint Camille Hospital in Ouagadougou, Burkina Faso. Sociodemographic data were collected through a questionnaire. The CD4 count and HIV-1 viral load were determined using respectively BD FACSCount and Abbott m2000rt instruments. Bivariate analysis and multinomial logistic regression were performed for associations with a significance threshold for p < 0.05. Results: The average age of women was 38.75 ± 7.98 years. Rates of MTCT, abortion and infant mortality were 16.31%, 30.49% and 34.75%, respectively. The number of pregnancies was associated with the number of infant deaths (p = 0.002). A correlation between the number of pregnancies and infant mortality was observed (p = 0.002) with a relatively high rate (28.6%) among women who had three pregnancies. In addition, marital status was associated with HIV-1 infection in infants (p = 0.042) and spontaneous abortion (p = 0.033). HIV-1 infected women with low CD4 counts (less than 350 cells/μL) and those with viral load more than 1000 copies/mL were about twice as likely to have an spontaneous abortion [OR (IC 95%): 2.50 (1.085 - 5.760); p = 0.03] and [OR (95% CI): 2.16 (1.043 - 4.505); p = 0.04]. Conclusions: The results of this study show the need to improve the treatment of HIV-1 infected women in order to restore CD4 levels and make viral load of HIV-1 undetectable.

[1]  G. Rezza,et al.  Reproductive desire among women living with HIV/AIDS in Central Brazil: Prevalence and associated factors , 2017, PloS one.

[2]  W. Awoke,et al.  Knowledge of pregnant women on mother-to-child transmission of HIV, its prevention, and associated factors in Assosa town, Northwest Ethiopia , 2016, HIV/AIDS.

[3]  A. Adimora,et al.  The Effects of Viral Load Burden on Pregnancy Loss among HIV-Infected Women in the United States , 2015, Infectious diseases in obstetrics and gynecology.

[4]  L. Traoré,et al.  [Evaluation of antiretroviral therapy on mother to child transmission HIV in HIV-1 positive pregnant women: case of St. Camillus Medical Center in Ouagadougou, Burkina Faso]. , 2015, The Pan African medical journal.

[5]  D. Elashoff,et al.  Factors associated with desire for children among HIV-infected women and men: A quantitative and qualitative analysis from Malawi and implications for the delivery of safer conception counseling , 2014, AIDS care.

[6]  S. Meshnick,et al.  Severity of Maternal HIV-1 Disease Is Associated With Adverse Birth Outcomes in Malawian Women: A Cohort Study , 2013, Journal of acquired immune deficiency syndromes.

[7]  E. Mmbaga,et al.  Fertility desire and intention of people living with HIV/AIDS in Tanzania: a call for restructuring care and treatment services , 2013, BMC Public Health.

[8]  O. Ezechi,et al.  O239 PREGNANCY, OBSTETRIC AND NEONATAL OUTCOME IN HIV POSITIVE NIGERIAN WOMEN , 2012 .

[9]  G. Aldrovandi,et al.  Pregnancy loss and role of infant HIV status on perinatal mortality among HIV-infected women , 2012, BMC Pediatrics.

[10]  H. Rees,et al.  High Incidence of Unplanned Pregnancy after Antiretroviral Therapy Initiation: Findings from a Prospective Cohort Study in South Africa , 2012, PloS one.

[11]  R. Barbosa,et al.  Exploring the relationship between induced abortion and HIV infection in Brazil , 2012, Reproductive health matters.

[12]  S. Nielsen,et al.  Dysregulation of CD4+CD25+CD127lowFOXP3+ regulatory T cells in HIV-infected pregnant women. , 2011, Blood.

[13]  Paige L. Williams,et al.  Declines in Mortality Rates and Changes in Causes of Death in HIV-1-Infected Children During the HAART Era , 2010, Journal of acquired immune deficiency syndromes.

[14]  M. Essex,et al.  Pregnancy Rates and Birth Outcomes Among Women on Efavirenz-Containing Highly Active Antiretroviral Therapy in Botswana , 2007, Journal of acquired immune deficiency syndromes.

[15]  F. Ceccherini‐Silberstein,et al.  Effective program against mother‐to‐child transmission of HIV at Saint Camille Medical Centre in Burkina Faso , 2007, Journal of medical virology.

[16]  C. Kendall,et al.  Desire for a child among women living with HIV/AIDS in northeast Brazil. , 2007, AIDS patient care and STDs.

[17]  E. Figueiró-Filho,et al.  Antiretroviral therapy during pregnancy and early neonatal life: consequences for HIV-exposed, uninfected children. , 2004, The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases.

[18]  S. Bergström,et al.  Post-abortion endometritis–myometritis and HIV infection , 2002, International journal of STD & AIDS.

[19]  P. Brocklehurst,et al.  The association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta‐analysis , 1998, British journal of obstetrics and gynaecology.

[20]  M. Lampe,et al.  Elimination of perinatal HIV infection in the United States and other high-income countries : achievements and challenges , 2015 .

[21]  S. Lockman,et al.  Highly active antiretroviral therapy and adverse birth outcomes among HIV-infected women in Botswana. , 2012, The Journal of infectious diseases.

[22]  Otros Temas.  Odds ratio , 2007 .