Background: Over the last decade, Ethiopia adopted different strategies of prevention of mother to child transmission\nof HIV (PMTCT). Prior to implementation of Option A in 2011, there was no provision of prophylaxis for PMTCT.\nWith ââ?¬Ë?Option Aââ?¬â?¢, PMTCT interventions relied on maternal CD4 count. In early 2013, ââ?¬Ë?ââ?¬Ë?Option B+ââ?¬â?¢Ã¢â?¬â?¢ has been started; with\nthis option, antiretroviral therapy is started and continued for life to any HIV positive pregnant mother irrespective\nof CD4 count with an enhanced treatment for the baby. Though there are a number of studies which evaluated the\neffectiveness of PMTCT interventions, the current study assessed the real-world effectiveness of PMTCT options in a\nsetting where there is limitation of resources.\nObjective: This study tried to address three questions: what proportion of babies tested by DNA-PCR are HIV infected\nin the first 2 months of life? How does the type of PMTCT intervention affect presence of HIV infection at this age?\nWhat are the factors affecting HIV transmission, after controlling for type of PMCT-HIV intervention?\nMethods: We assessed records of 624 registered HIV exposed infants and 412 mothers who were delivered at Bishoftu\nHospital from May 2006 to August 2014. Presence of HIV infection at 6ââ?¬â??8 weeks of age was assessed from the\nrecords. Maternal and infant risk factors for infection at this age were analyzed. Data were collected using standard\ndata abstraction format and were analyzed using SPSS version 20.\nResults: Among all the infants who were delivered at the hospital during the study period, 624/936 (66.7 %) had\nundergone early infant diagnosis at 6ââ?¬â??8 weeks. Twenty-seven (4.3 %) were positive for HIV DNA PCR at the age of\n6ââ?¬â??8 weeks. None of the infants who received ââ?¬Ë?ââ?¬Ë?Option B+ââ?¬â?¢Ã¢â?¬â?¢ had a positive HIV DNA PCR result. HIV infection rate was\nhighest among those who took either no prophylaxis or single dose Nevirapine (11.5 and 11.1 % respectively). Those\nwho took single dose Nevirapine and Zidovudine had HIV positivity rate of 3.9 %. Many of the covariates which were\nshown to be predictors on bivariate analysis were found not to be independent predictors on multivariate analysis.\nConclusion: PMTCT ââ?¬Ë?ââ?¬â?¢Option B+ââ?¬â?¢Ã¢â?¬â?¢ resulted in zero HIV infection rates among the included infants. There was a high\nloss to follow up rate at 6ââ?¬â??8 weeks of age. The authors recommend that a better strategy of linkage to care and treatment\nshould be devised for HIV exposed infants
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