P6.063 Vertical Transmission of HIV by Age of Infant Testing and Type of Mother/Infant Prophylaxis in Tigray, Ethiopia

Abstract

Background: Following a number of other African countries, Ethiopia has recently adopted option B+ as the national PMTCT standard. Option B+ puts all HIV-positive pregnant women on HAART for life, regardless of the CD4 count. This study examines whether HAART for maternal prophylaxis resulted in lower vertical HIV transmission in Tigray. Method(s): We used data from Tigray's regional DBS data base to calculate HIV infection rates by PMTCT regimen in all HIV-exposed infants (HEIs) tested by December 2012. We calculated the relative risk (RR) of having a HIV+ baby by age of testing and the mother's PMTCT regimen. Result(s): There was a significant difference in HIV rates between babies tested at 0-2 months (4%) and 2-8 months (9%) (RR = 0.43, CI = 0.28.0.65; p = 0.0001). HIV infection was significantly higher in babies tested past 8 months (16%) (respectively, RR = 0.23, CI = 0.14.0.38; p < 0.0001 and RR = 0.55, CI = 0.36.0.86; p = 0.005). Maternal prophylaxis was a significant factor with a further significant difference between HAART (2%) and dual prophylaxis (14%) (RR = 0.37; CI = 0.19.0.74; p = 0.006). Conclusion(s): This study underscores the importance of putting HIV-positive pregnant mothers on PMTCT, especially HAART, and promoting institutional delivery and early infant testing. HAART was the most effective PMTCT regimen, regardless of the infant's regimen. This finding is particularly important in Ethiopia where most women give birth at home and may not be able to give the right medication to their baby at the right time. This data strongly supports the validity of option B+ as the national PMTCT standard in Ethiopia.