Progress in the Prevention of Mother to Child Transmission of HIV in Three Regions of Tanzania: A Retrospective Analysis

BACKGROUND: Mother to child transmission (MTCT) of HIV-1 remains an important problem in sub-Saharan Africa where most new pediatric HIV-1 infections occur. Early infant diagnosis of HIV-1 using dried blood spot (DBS) PCR among exposed infants provides an opportunity to assess current MTCT rates. METHODS: We conducted a retrospective data analysis on mother-infant pairs from all PMTCT programs in three regions of northern Tanzania to determine MTCT rates from 2008-2010. Records of 3016 mother-infant pairs were assessed to determine early transmission among HIV-exposed infants in the first 75 days of life. RESULTS: Of 2266 evaluable infants in our cohort 143 had a positive DBS PCR result at nevirapine (sdNVP) or combination prophylaxis respectively; the lowest MTCT rates occurred when women were on HAART with 2.1% transmission (0.3 3.9). Treatment regimens changed dramatically over the study period with an increase in combination prophylaxis and a decrease in the use of sdNVP. Uptake of DBS PCR more than tripled over the period of study for the three regions surveyed. CONCLUSIONS: Our study demonstrates significant reductions in MTCT of HIV-1 in three regions of Tanzania coincident with increased use of more effective PMTCT interventions. The changes we demonstrate for the period of 2008-2010 occurred prior to major changes in WHO PMTCT guidelines.