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Table 1 Studies conducted in low-and middle-income countries, which achieved a six-month mother-to-child HIV transmission rate of ≤5%

From: Evaluation of a community health worker intervention and the World Health Organization’s Option B versus Option A to improve antenatal care and PMTCT outcomes in Dar es Salaam, Tanzania: study protocol for a cluster-randomized controlled health systems implementation trial

Country

Year

Participants

Maternal regimen

Infant regimen

Transmission rate at 6 months (95% confidence interval)

Botswana[3]

2006-2008

730 breastfeeding women1

Triple ARVs from 28-34 weeks until cessation of breastfeeding2

sd-NVP + AZT for 4 weeks

1.1% (0.5%-2.2%)

Rwanda[4]

2005-2007

Mothers of 227 breastfed and 305 formula-fed infants

Formula-feeding: triple ARVs from 28 weeks until birth. Breastfeeding: triple ARVs until cessation of breastfeeding2

sd-NVP + AZT for 7 days

Breastfed: 1.8%3 (0.7%-4.8%)

Formula-fed: 1.0%3 (0.3%–3.0%)

Mozambique[5]

2005-2007

341 breastfeeding mother-infant pairs

Triple ARVs from 15 weeks until cessation of breastfeeding2

sd-NVP + AZT for 7 days

2.1%

Mozambique, Malawi, and Tanzania[6]

2004-2006

809 formula-feeding women

Triple ARVs from 25 weeks until cessation of breastfeeding2

sd-NVP + AZT for 7 days

2.7%

Burkina Faso, Kenya, South Africa[7]

2005-2008

Mothers of 805 infants4,5

Group 1: triple ARVs from 28-36 weeks until cessation of breastfeeding2,6

sd-NVP + AZT for 7 days

Group 1: 4.9% (3.1%-7.6%)

Group 2: AZT during pregnancy + sd-NVP and AZT at onset of labor7,8

Group 2: 8.4% (6.0%-11.6%)

Kenya[8]

2003-2009

Mothers of 487 breastfed infants

Triple ARVs from 34-36 weeks until cessation of breastfeeding2

sd-NVP

5.0% (3.4%-7.4%)

Tanzania[9]

2004-2006

Mothers of 441 breastfed infants

Triple ARVs from 34 weeks until cessation of breastfeeding2

AZT + 3TC for 7 days

5.0% (3.2%-7.0%)

  1. 3TC, lamivudine; ARV, antiretroviral drugs; AZT, zidovudine; NVP, nevirapine; sd-NVP, single dose of nevirapine at birth.
  2. 1Of these 730 women, 560 had a CD4-count ≥200 cells/mm3 and 170 a CD4-count <200 cells/mm3 or an AIDS-defining illness.
  3. 2Women were advised to have concluded complete cessation of breastfeeding by 6 to 7 months postpartum, depending on the study.
  4. 3These are transmission rates at 9 months (not 6 months).
  5. 478% of infants born to women in each arm of the study were ever breastfed.
  6. 5This is the number of participants randomized at the beginning of the study.
  7. 6349 infants’ mothers were provided with this regimen.
  8. 7339 infants’ mothers were provided with this regimen.
  9. 8After a protocol amendment in 2006, women in the AZT arm also received AZT + 3TC 7 days postpartum.
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Trials

ISSN: 1745-6215