Incidence of HIV-infected infants born to HIV-infected mothers with prophylactic therapy: Preliminary report of hospital birth cohort study

Background Human immunodeficiency virus (HIV) is expanding rapidly and was reported double in several places in Indonesia To our knowledge, reports regarding HIV-infected infants are still scarce. Objectives To investigate the incidence of HIV-infected infants born to HIV-mothers who had received prophylaxis therapy at birth. Methods A prospective hospital-based cohort study was held from January 2003 until December 2004 in Cipto Mangunkusumo Hospital, Jakarta. The inclusion criteria were mothers with positive HIV and their infants had been given anti retroviral (ARV) therapy. The babies were followed up monthly and the status of infection was determined by PCR at the age of 4 weeks and 6 months. Outcome was measured based on PCR assays or clinical signs of HIV infection. Results The mothers' age ranged from 19 to 27 years. All of them were carrying their first child and only 41% mothers took ARV prophylaxis. Almost all mothers underwent caesarean section and the infants had formula feeding. HIV infection was diagnosed in 7 infants and 2 of them had RNA assays more than 5,000 copies/ml. Six infants were negatives whereas 3 infants were diagnosed as indeterminate HIV infection and needed further examination. One needed no further investigation as the mother was seronegative. Conclusions Preventing HIV transmission from mother to infant can be done by giving ARV during prenatal, intrapartum, and postnatal period to the newborn. In our hospital, transmission was confirmed in 6 of 17 infants. Unison protocol must be used and population of HIV-pregnant mother must be registered in order to know how high the transmission rate among Indonesian HIV people.