Antiretroviral Treatment Initiation Among HIV-Infected Pregnant Women with Low CD4+ Cell Counts in Gaborone, Botswana

BACKGROUND:Botswana has the most comprehensive public program in Africa for providing antiretroviral therapy to treat HIV and prevent mother-to-child transmission (PMTCT). Botswana guidelines prioritize CD4 cell count testing during pregnancy and initiation of highly active antiretroviral treatment...

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Published in:	Journal of acquired immune deficiency syndromes (1999) Vol. 54; no. 1; pp. 102 - 106
Main Authors:	Chen, Jennifer Y, Ogwu, Anthony C, Svab, Petr, Lockman, Shahin, Moffat, Howard J, Gaolathe, Tendani, Moilwa, Shana, Størdal, Ketil, Dryden-Peterson, Scott, Moffat, Claire, Makhema, Joseph, Essex, M, Shapiro, Roger L
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-05-2010 Lippincott Williams & Wilkins Lippincott Williams & Wilkins Ovid Technologies
Subjects:	Adolescent Adult AIDS/HIV Anti-HIV Agents - therapeutic use Antiretroviral drugs Biological and medical sciences Botswana CD4 Lymphocyte Count Cells Disease transmission Drug therapy Female Fundamental and applied biological sciences. Psychology Health Services Research HIV HIV Infections - drug therapy Human immunodeficiency virus Human viral diseases Humans Infectious diseases Maternal & child health Medical sciences Microbiology Miscellaneous Pregnancy Pregnancy Complications, Infectious - drug therapy Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology Women Young Adult Botswana Africa Gaborone Botswana Human Immunopathology Antiretroviral agent HAART initiation pregnancy AIDS cell count testing Immune deficiency Infection CD4 Treatment Viral disease Botswana Antiviral Female
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Summary:	BACKGROUND:Botswana has the most comprehensive public program in Africa for providing antiretroviral therapy to treat HIV and prevent mother-to-child transmission (PMTCT). Botswana guidelines prioritize CD4 cell count testing during pregnancy and initiation of highly active antiretroviral treatment (HAART) for women who qualify for treatment. We analyzed rates of HIV testing, CD4 cell count testing, and HAART initiation during pregnancy. METHODS:From October 2007 through June 2008, we reviewed obstetric and laboratory records of women at Princess Marina Hospital in Gaborone, Botswana. RESULTS:We recorded information from 3056 women. Of 2675 women eligible for the PMTCT program, 2623 (98%) had a documented HIV status, of whom 793 (30%) were HIV infected. Among women who were treatment naive at pregnancy conception, 397 (59%) had recorded CD4 cell counts, of whom 62 (16%) had a CD4 cell count <200 cells per cubic millimeter. Among this subset, 23 (37%) initiated HAART during pregnancy, 26 (42%) received zidovudine prophylaxis, and 13 (21%) received no therapy. CONCLUSIONS:We observed low rates of CD4 cell count testing and HAART initiation during pregnancy. Antenatal clinics should prioritize CD4 cell count testing and referral of women who qualify for HAART to maximize benefits of maternal treatment and PMTCT.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1525-4135 1944-7884
DOI:	10.1097/QAI.0b013e3181c080bf