Simporé, Jacques and Pietra, Virginio and Pignatelli, Salvatore and Karou, Damintoti and Nadembega, Wendyame M. C. and Ilboudo, Denise and Ceccherini-Silberstein, Francesca and Ghilat-Avoid-Belem, W. N. and Bellocchi, Maria Concetta and Saleri, Nuccia and Sanou, Marie-Joseph and Ouedraogo, Charlemagne and Nikiema, Jean Baptiste and Colizzi, Vittorio and Perno, Carlo Federico and Castelli, Francesco and Musumeci, Salvatore (2007) Effective program against mother-to-child transmission of HIV at Saint Camille Medical Centre in Burkina Faso. Journal of Medical Virology, Vol. 79 (7), p. 873-879. eISSN 1096-9071. Article.
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The present research was aimed to prevent mother-to-child transmission of HIV; to use RT-PCR in order to detect, 6 months after birth, infected children; and to test the antiretroviral resistance of both children and mothers in order to offer them a suitable therapy. At the Saint Camille Medical Centre, 3,127 pregnant women (aged 15-44 years) accepted to be enrolled in the mother-to-child transmission prevention protocol that envisages: (i) Voluntary Counselling and Testing for all the pregnant women; (ii) Antiretroviral therapy for HIV positive pregnant women and for their newborns; (iii) either powdered milk feeding or short breast-feeding and RT-PCR test for their children; (iv) finally, pol gene sequencing and antiretroviral resistance identifications among HIV positive mothers and children. Among the patients, 227/3,127 HIV seropositive women were found: 221/227 HIV-1, 4/227 HIV-2, and 2/227 mixed HIV infections. The RT-PCR test allowed the detection of 3/213 (1.4%) HIV infected children: 0/109 (0%) from mothers under ARV therapy and 3/104 (2.8%) from mothers treated with Nevirapine. All children had recombinant HIV-1 strain (CRF06_CPX) with: minor PR mutations (M36I, K20I) and RT mutations (R211K). Among them, two twins had Non-Nucleoside Reverse Transcriptase Inhibitor mutation (Y18CY). Both mothers acquired a major PR mutation (V8IV), investigated 6 months after a single-dose of Nevirapine. Prevention by single-dose of Nevirapine reduced significantly mother-to-child transmission of HIV, but caused many mutations and resistance to antiretroviral drugs. Based on present study the antiretroviral therapy protocol, together with the artificial-feeding, might represent the ideal strategy to avoid transmission of HIV from mother-to-child.
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