Early Outcomes of HIV Exposed Children in the First District-wide Programme using Extended Regimens for the Prevention of Mother-to-Child Transmission of HIV, in Yaounde, Cameroon

OBJECTIVE: Report on the early outcomes achieved in the prevention of mother-to-child transmission (PMTCT) programme in the Djoungolo Health District using more effective antiretroviral PMTCT regimens. METHODS: Observational cohort of HIV exposed infants. MAIN OUTCOME MEASURE: early infant HIV status and 3-month mortality rate. RESULTS: From March 2008 to March 2010 587 HIV-positive mother-baby pairs were enrolled and classified according to the following maternal antiretroviral regimen: Group 1: highly active antiretroviral therapy (HAART) Group 2: dual therapy Group 3: no treatment. 484/587 (82%) underwent HIV-early infant diagnosis at a median age of 7 weeks; 4.5% (95% CI 2.65-6.34) were HIV-infected. HIV transmission rate differed by maternal prophylaxis: 1.7% for HAART 2.7% for dual therapy and 15.7% for Group 3 (p < 0.001) but not by feeding method (2.74%)-exclusive breastfeeding vs. 5.34% formula (NS). The 3-month mortality rate stands at 1%. CONCLUSIONS: The 4.5% MTCT-rate of HIV-1 reported confirms the feasibility and effectiveness of a district wide PMTCT programme using HAART in low-income settings.