OBJECTIVE:To determine the percentage of infected children for whom nevirapine (NVP) was used to prevent peripartum mother-to-child transmission (MTCT) of HIV in Yaoundé, Cameroon. DESIGN:The study was a prospective Public Health Pilot Program covering a 3-year period (January 2000-December 2002). METHODS:Counseled and consenting HIV-1-positive pregnant women were given a single dose of NVP at the onset of labor. Babies were given 2 mg/kg NVP syrup within the first 72 hours of life. NVP-treated children were regularly followed up and examined for HIV-1 infection at 6-8 weeks and 5-6 months through plasma viral load (VL) quantification with the bDNA system. RESULTS:One hundred twenty-three children were diagnosed with perinatal HIV-1 infection at 6-8 weeks and 5-6 months. Thirteen children (10.6% [13/123]; 95% confidence interval, 5.1-16) were infected and presented with high VLs, in general >500,000 copies/mL. Two children had intermediate VLs (between 50 and 3500 copies/mL) at both time points. One hundred seven children (87%) were considered not infected at 6-8 weeks of age. CONCLUSIONS:Our results indicate that the HIV-1 MTCT rate 6-8 weeks after NVP administration was not >13% (16/123), thus demonstrating the effectiveness of NVP for lowering the risk of HIV-1 MTCT in real-life settings.

译文

目的:确定在喀麦隆雅温得使用奈韦拉平(NVP)预防围产期HIV母婴传播(MTCT)的感染儿童的百分比。
设计:该研究是一项为期三年的前瞻性公共卫生试验计划(2000年1月至2002年12月)。
方法:在接受咨询的自愿同意的HIV-1阳性孕妇在分娩时给予单剂量的NVP。婴儿在出生后的头72小时内应服用2 mg / kg NVP糖浆。对接受NVP治疗的儿童进行定期随访,并通过bDNA系统定量血浆病毒载量(VL)对6-8周和5-6个月的HIV-1感染进行检查。
结果:123名儿童在6-8周和5-6个月被诊断为围产期HIV-1感染。十三名儿童(10.6%[13/123]; 95%置信区间为5.1-16)被感染并呈现出较高的VL,通常> 500,000拷贝/ mL。两个孩子在两个时间点都有中度VLs(介于50和3500拷贝/ mL之间)。认为有67名儿童(87%)在6-8周龄时未感染。
结论:我们的结果表明,NVP给药后6-8周的HIV-1 MTCT发生率未> 13%(16/123),因此证明了NVP在现实环境中降低HIV-1 MTCT风险的有效性。 。

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