Incidence of Mother-to-Child Transmission of HIV and Associated Factors in Postpartum Women in Cameroon.

Abstract

Background and objective: Human immunodeficiency virus (HIV) infection attacks and gradually weakens the immune system by destroying CD4 cells, with the most advanced stage of the infection known as acquired immunodeficiency syndrome (AIDS). Mother-to-child transmission (MTCT) of HIV remains the primary method of infection among children. Understanding the factors contributing to MTCT and current transmission rates is crucial for developing effective prevention strategies during pregnancy, childbirth, and breastfeeding. This study aims to determine MTCT of HIV, assess maternal viral load, and identify transmission-associated factors in the Adamawa Region of Cameroon.

Methods: Blood samples were collected from 119 mothers living with HIV and their children (mother-infant pair) in 15 different HIV/AIDS treatment units/facilities across the Adamawa Region and analyzed at the Ngaoundere Regional Hospital. Early infant diagnosis was performed using the GenXpert system, and viral load quantification was performed using the Cobas 5800 system.

Results: The findings showed that the MTCT rate of HIV was 1.7% (2/119), with an incidence rate of 33.6 cases/1000 person-years. Maternal viral load suppression rate was 96.6% (115/119). Among the participants, 47.1% (56/119) had undetectable viral loads (<20 copies/mL) and 49.6% (59/119) had suppressed viral loads of 20-<1000 copies/mL. Only 3.4% (4/119) had unsuppressed viral loads ≥1000 copies/mL. There was no statistically significant association between maternal age, duration of antiretroviral therapy (ART), type of ART, and number of antenatal visits. Significant associations were observed between MTCT and place of birth (p = 0.001) and maternal viral load (p < 0.001).

Conclusions and global health implications: The transmission rate of HIV infection in infants born to HIV-positive mothers was below the national target of 2%. There was high viral suppression in lactating mothers, which was associated with a high adherence rate to ART. Maternal viral load and delivery location were significant risk factors for transmission.