Maternal risk classification and perinatal mother to child transmission at Mahosot and Setthathirath Hospital
- Author:
Anousone Rasaphonh
1
;
Pope Kosalaraksa
2
;
Surapon Wiangnon
2
;
Mayfong Mayxay
3
;
Bandith Soumphonphakdy
4
Author Information
- Collective Name:LMJ
- Publication Type:Journal Article
- Keywords: AIDS, HIV, PMTC, MTCT
- From:Lao Medical Journal 2023;14(14):48-56
- CountryLao People's Democratic Republic
- Language:English
-
Abstract:
Introduction: :Most of the children in Laos who are infected with the human immunodeficiency virus (HIV) contract it through perinatal mother to child transmission (PMTCT). One major risk factor for this transmission is the maternal viral load during the peripartum period. Consequently, the maternal risk classification for MTCT, based on maternal viral load, duration of antiretroviral treatment (ART), and adherence, has been widely used but has not been universally applied in Laos.
Objectives: :To evaluate the maternal clinical risk classification and perinatal mother to child transmission at Mahosot and Setthathirath Hospital.
Methodology: :This retrospective descriptive study was conducted at the Infectious Diseases Department of Mahosot and Setthathirath hospitals in Vientiane Capital, Laos, from January 2016 to December 2020. Data were analysed using SPSS version 26.
Results: :A total of 430 HIV-infected mothers were included in the study, with 299 (69.5%) being newly diagnosed, and 251 (58.4%) identified during pregnancy. According to the WHO classification, 70.9% were at stage 1 (asymptomatic). Among pregnant mothers, 62.1% were on the tenofovir/lamivudine/dolutegravir regimen, while 37.9% were on zidovudine/lamivudine/nevirapine. All 430 infants received zidovudine (AZT) or AZT + nevirapine as postpartum prevention, with 259 (60.2%) completing 4 weeks of AZT. In terms of risk classification, 257 (59.8%) mothers were categorized as standard risk. Overall, 53 out of 430 (12.3%) children were diagnosed with HIV infection at 18 months of age. The MTCT rate was 3 out of 257 (1.2%) for mothers in the standard-risk group and 50 out of 173 (28.9%) for those in the high-risk group.
Conclusion: :The HIV PMTCT rate in Laos remains high, especially among HIV-infected mothers at high risk. Therefore, early detection of HIV infection, prompt initiation of ART in HIV-infected pregnant women, and the use of risk classification to select postpartum prophylaxis regimens are crucial steps in reducing the number of new HIV-infected infants in Laos. - Full text:2026030212153238433ບົດທີ_05. Dr. Anousone Manuscript (LMJ_14).pdf
