Effectiveness of a Prevention of Mother-to-Child HIV Transmission Programme in an Urban Hospital in Angola 英文参考文献.docVIP

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Effectiveness of a Prevention of Mother-to-Child HIV Transmission Programme in an Urban Hospital in Angola 英文参考文献.doc

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Effectiveness of a Prevention of Mother-to-Child HIV Transmission Programme in an Urban Hospital in Angola 英文参考文献

EffectivenessofaPreventionofMother-to-ChildHIV TransmissionProgrammeinanUrbanHospitalinAngola CristinaLussiana1*,SofiaVandaLo?aClemente2,AngeloGhelardi3,MagdaLonardi4 ,Ivan AlejandroPulidoTarquino5,MarcoFloridia6 1Infectious Diseases Laboratory, Hospital Divina Providencia, Luanda, Angola, 2Clinical Direction, Hospital Divina Providencia, Luanda, Angola, 3Project Direction, Hospital Divina Providencia, Luanda, Angola, 4Pediatric Department, Hospital Divina Providencia, Luanda, Angola, 5Infectious Diseases Laboratory, Hospital Divina Providencia,Luanda,Angola,6DepartmentofTherapeuticResearchandMedicinesEvaluation,IstitutoSuperiorediSanita`, Rome,Italy Abstract Background: Antiretroviral therapy is effective in reducing rates of mother-to child transmission of HIV to low levels in resource-limitedcontextsbuttheapplicabilityandefficacyoftheseprogramsinthefieldarescarcelyknown.Inorderto exploresuchissues,weperformedadescriptivestudyonretrospectivedatafromhospitalrecordsofHIV-infectedpregnant womenwhoaccessedin2007–2010theLuandaMunicipalHospitalserviceforpreventionofmother-to-childtransmission (PMTCT).ThemainoutcomemeasurewasinfantsurvivalandHIVtransmission.OuraimwastoevaluatePMTCTprogramme inalocalhospitalsettinginAfrica. Results: Data for 104 pregnancies and 107 infants were analysed. Sixty-eight women (65.4%) had a first visit before or duringpregnancyandreceivedcombinationantiretroviraltreatment(ART)inpregnancy.Theremaining36women(34.6%) presented after delivery and received no ART during pregnancy. Across a median cohort follow-up time of 73 weeks, mortalityamongwomenwithandwithoutARTinpregnancywas4.4%and16.7%,respectively(deathhazardratio:0.30, 95%CI0.07–1.20,p=0.089).TheestimatedratesofHIVtransmissionordeathintheinfantsoveramedianfollowuptimeof 74weekswere8.5%withmaternalARTduringpregnancyand38.9%withoutmaternalARTduringpregnancy.Following adjustment for use of oral zidovudine in the newborn and exposure to maternal milk, no ART in pregnancy remained asso