Impact of changed NACO Guidelines on HIV Vertical Transmission at Tertiary Referral Institute in Mumbai
Dr Reena Wani, Dr Pramila Yadav, Dr Yesha Sevalia, Dr Suyasha Thorat
Objective : To assess the impact of changed guidelines of National AIDS Control Program on vertical transmission at our centre. Design: Retrospective analysis of outcomes of standard treatment as per revised national guidelinesSetting: H B T Medical College and Dr. R N. Cooper Hospital Mumbai.Methods: All antenatal (ANC) cases over 4 years (2015 to 2018), sero-positive women delivering at our institute, and newborns screened for HIV by DBS (dried blood spot) testing as per NACO Guidelines were reviewed.Results : Out of 18,342 ANC cases registered over 4 years, totally 16,664 were screened using opt-out policy (91%). Overall 25 cases (0.15%) were detected to be HIV positive, with a decreasing trend over the 4 years. However 0.6% (100) of antenatal women were seropositive as many (75) had been referred to us for delivery due to sero-positive status. Of the 75 livebirths, 65 (86.7%) neonates underwent DBS testing and all tested negative. In the last 4 years there has been ZERO positivity - 100% prevention of vertical transmission of HIV in those tracked.Conclusion: The rate of vertical transmission can be reduced to zero by antenatal screening, highly active anti retroviral therapy (ARV) during antenatal and intra-natal period and treating newborns with ARV as per revised NACO Guidelines.
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