PERINATAL HIV
TRANSMISSION AND ITS RISK FACTORS:
A PROSPECTIVE
STUDY
Kulkarni M. L, Jain T
J. J. M. Medical College, Davangere, India
Objectives: To determine the seroprevalence rate
of HIV positive pregnant women in major teaching hospital in Davangere,
Karnataka, India, and to determine the vertical transmission rate of HIV in
babies born to these HIV seropositive women with emphasis to evaluate the
possible maternal, obstetrics, new born and feeding factors influencing
them.
Method: 11,289 pregnant women admitted for
delivery were screened for HIV after appropriate pretest counseling and
consent for HIV testing followed by post test counseling. HIV serology was
done by ELISA/DOT BLOT method, according to WHO protocol. Babies born to
HIV seropositive women were followed for a period of 18 months and serial
ELISA tests for HIV was done every three months.
Result: Of the 11,289 pregnant women screened for
HIV, 80 were found to be HIV seropositive (sero prevalance rate of 0.6%).
Among the 80 babies born to HIV seropositive mothers, 44 babies could be
followed for 18 months. At the end of 12 months 28.6% babies remained HIV
seropositive and at the end of 18 months 22.2% babies remained HIV
seropositive (Vertical transmission rate - 22.2%). Perineal tear, prolonged
rupture of membranes previous history of intrautrine death and sibling
death were found to be the risk factors for increased vertical transmission
rate and so also, was breast feeding. We did not find any difference among
the rural and urban, rich and poor, as far as the prevalence and vertical
transmission rates were concerned.
Conclusion: The HIV seroprevalence rate among
pregnant women as well as the vertical transmission rate is much lower
compared to other parts of our country. Determination of possible risk
factors associated with vertical transmission of HIV could be helpful in
executing an appropriate intervention, thus giving us an opportunity to
contain this burning problem.