Background: Success in preventing HIV transmission from mother to child has been confirmed, however intervention remains difficult in both services and access barriers due to discrimination and stigma. Objectives: To clarify the HIV prevalence in pregnant women and evaluate the indicators related to the impact of intervention on prevention of mother-to child transmission of HIV. Subjects and method: This study was carried out in 5 districts in 5 provinces that implemented the Prevention of Mother to Child Transmission (PMTCT) Project. The interventions included the training to provide knowledge, skills on counseling, testing and supervision on PMTCT. The data were collected from designed-questionaires. Results:The results showed there are 100% of pregnant women that came for antenatal visits, had voluntary test counseling. The prevalence of HIV (+) among pregnant women was 0,43%. There were 57 infants born to mothers with HIV (+); received prophylaxis treatment. At the time of the study, there were 31 infants at 18 months of age that received HIV test and all of them were confirmed as negative. Conclusion: Intervention on PMTCT was effectively achieved and should be expanded nationally. Communication, counseling is very important to encourage pregnant women with HIV (+); visit for antenatal care, followed up by health facility and strict adherence to the PMCT schedule to diminish the chance of transmission to their infants.
Prevention of Mother to Child transmission ; HIV testing counseling ; HIV voluntary test.

Background: Previous studies showed that B hepatitis prevalence in Vietnam was very high, and the rate of mother-to-child transmission ranged from 44.7% to 45.2%. And nearly 90% of infected babies will become chronic carriers in later life. Objectives: To determine the rates of the HBeAg, DNA-HBV markers and capacity of mother-to-child transmission among the positive-HBsAg pregnant women in Hanoi. Subjects and method: The cross-sectional study was carried out on 163 positive-HBsAg pregnant women admitted to the Hanoi Obstetrical Hospital from 6/2005 to 3/2007. Blood samples were collected from both mothers and neonates immediately after birth for analysis of HBeAg and DNA-HBV markers. Results:66/163 (40.5%) mothers had HBeAg marker. Among 67 positive-HBsAg pregnancies, 38 women (56.7%) had DNA-HBV marker. The rate of mother-to-child transmission of positive-HBsAg mothers was 55.2%. 96.3% of mothers with HBsAg(+)/HBeAg(+) transmitted HBV to their babies. The risk of HBsAg(+) increased 68.6 times in babies of mothers with HBsAg(+)/HBeAg(+) versus babies of mothers with HBsAg(+) alone. Among babies of mothers with DNA(+), 89.5% had HBsAg(+). The risk of HBsAg(+) in babies of mothers with DNA(+) was 73.7 times higher than that in babies of mothers with DNA(-). Conclusion: Babies that were born from HBsAg(+)/HBeAg(+) mothers had high risk of becoming chronic carriers.
HBeAg marker ; DNA-HBV marker ; mother-to-child transmission ; positive HBsAg pregnant women

OBJECTIVETo explore the antiviral efficacy, safety and protective ability against mother-to-infant transmission of telbivudine in pregnant patients with chronic hepatitis B (CHB) during the first trimester.

METHODSEighty four gravid women who were diagnosed with CHB, in their first trimester of pregnancy, and had refused to terminate their pregnancies were enrolled; all study participants were clinically classified as active hepatitis cases with positivity for both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg), HBV DNA more than or equal to 107 copies/mL and serum level of alanine aminotarnsferase (ALT) of more than or equal to 4 ULN.Patients with YMDD mutations were excluded from the study. The study participants were divided into a telbivudine treatment group (n=43; administered in the first trimester of pregnancy) and a control group (n=41, consisting of patients who refused to take antivirals). All babies bom to the women in both groups of the study received standard immune prevention (anti-hepatitis B immunoglobulin plus hepatitis B vaccine) and artificial feeding.Data recorded for the women during pregnancy included clinical findings for tests of hepatic and renal function, myocardial enzymes, blood and urine clinical parameters, hepatitis B virus makers and HBV DNA, as well as notation of any adverse reactions. The neonates were evaluated for presence of HBV infection, parameters of growth and development, presence of complications, and Apgar score. At 6 and 12 months old, all infants were evaluated for HBV DNA level and HBsAg presence.

RESULTSThe genetic variant rtM204I was detected in one of the women in the treatment group at 36 weeks of pregnancy. One woman in the control group developed severe hepatitis at 28 weeks of pregnancy and was put on the telbivudine treatment The treatment group showed greater recovery rates of ALT than the control group at 12 weeks of pregnancy (62.8% vs.29.3%, P=0.002), 24 weeks of pregnancy (76.7% vs.46.3%, P=0.000), and at ante partum (88.1% vs.60.0%, P=0.004). The treatment group also showed greater HBV DNA-negative conversion rates at 12 weeks of pregnancy (20.9% vs.0, P=0.006), at 24 weeks of pregnancy (37.2% vs.0, P=0.001) and at ante partum (78.6% vs.0, P=0.000), and greater HBeAg seroconversion rates at 12 weeks of pregnancy (2.3% vs.0, P=1.000), at 24 weeks of pregnancy (9.3% vs.0, P=0.116) and at ante partum (2 1.4% vs.0, P=0.002). The HBsAg-positive rates and HBV DNA-positive rates among the infants born to the mothers in the treatment and control groups, respectively, were 2.4% vs.17.5% (P=0.027) at birth, 0 vs.17.5% (P=0.005)at 6 months old and 0 vs.17.5% (P=0.005) at 12 months old. The Apgar scores were not significantly different for the children born to the mothers from the two groups, and all the children showed parameters of growth development within normal limits.

CONCLUSIONTelbivudine administration in the first trimester had a good antiviral curative effect and effectively blocked mother-to-infant transmission in women with CHB. The treatment was safe, causing no obvious adverse reaction in the gravid women or developmental effects on the infants.

Antiviral Agents ; DNA, Viral ; Female ; Hepatitis A Vaccines ; Hepatitis B Vaccines ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Mother-Child Relations ; Mutation ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Trimester, First ; Thymidine ; analogs & derivatives ; Vaccines, Combined