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Year : 2013  |  Volume : 1  |  Issue : 2  |  Page : 70-76

Appraisal of repeat intrapartum human immunodeficiency virus screening in a prevention of mother-to-child transmission program in Nigeria

1 Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Benin, Edo, Nigeria
2 Department of Child Health, University of Benin Teaching Hospital, Benin, Edo, Nigeria
3 Department of Child Health, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America

Correspondence Address:
Joseph U. E. Onakewhor
Department of Obstetrics and Gynecology, University of Benin and University of Benin Teaching Hospital, Benin City - 300 001, Edo, Nigeria.

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2321-9157 .126634

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Objective: The objective of the study is to determine whether retesting for human immunodeficiency virus (HIV) in labor is important in Nigeria. Subjects and Methods: A prospective cohort study involving 400 antenatal women who tested HIV-negative at booking in an obstetric unit of a university college hospital in Nigeria were retested in labor at least 12 weeks from initial tests. Seropositive mothers and exposed infants had antiretroviral prophylaxis and were followed-up. Main outcome measures were rate of acceptance to rescreen, incidences of seroconversion, mother-to-child transmission and associated factors. Results: Majority 96.4% (400/415) accepted whereas 3.6% (15/400 N) declined retesting on the grounds of a previous negative result. The seroconversion rate was 0.25%. Maternal age ≥25 years (OR = 5.0), secondary and post-secondary education (OR = 622.4) and parity ≥1 (OR = 17.2) were significant factors for acceptance to rescreen whereas occupation (P = 0.25) and marital status (P = 0.23) were not. The only HIV-exposed infant from the seroconverted mother was not breastfed and tested negative at 6 and 12 weeks using deoxyribonucleic acid polymerase chain reaction. Conclusion: The rate of seroconversion was low, but perinatal HIV infection was averted. Supposedly low-risk women could seroconvert and cause vertical transmission (VT). Retesting may still be important in resource-constrained settings to identify women with recent infection, institute appropriate interventions to avert VT thereby achieving the international goal of "no new HIV infection by 2015". Although a large multicenter study to evaluate our findings is ongoing, studies to determine the cost-benefits of such interventions are justified.

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