Clinical and Laboratory profiles of pregnant HIV positive Nigerians at enrollment: Implications for maternal, newborn and drug regimen choice in the country

This study was conducted to determine the appropriateness of the new national guideline taken into cognizance the clinical and laboratory profile of HIV positive pregnant Nigerians. Review of programmatic data obtained between 2004 and 2013. 5644 pregnant HIV positive women were enrolled into the PMTCT programme during the period. Of these, 5486 (97.2%) were pregnant and 158 (2.8%) presented within 72 hours of delivery. The majority of the women (66.7%) have had at least one previous delivery, with median and mean parity of 1 and 1.6 ± 0.93 respectively. Sixteen (1.7%) mothers had previously had six deliveries. The mean and median gestational age at booking was 28.1 ± 6.1 and 31 weeks respectively. Onethousand five hundred and twenty nine (27.1 %) mothers were already on HAART at enrolment. Majority (59.8%; 3375) of the women had HIV viral load above 10,000copies/ml, with only 17.2% (971) having viral load below 1000 copies. Majority of the mothers had CD4 cell count below 500 cells/mm3 (81.8%). Majority (3906; 72.3%) had Hb of less than 11g/dl and the remaining and 1738(27.7%) women had Hb greater than 11g/dl. The current guideline recommendation for pregnant women and children seem safe based on the finding in this study. However it should be reviewed from time to time.