A Facility-Based Study of Socio-clinical Predictors of Treatment Outcomes Among Human Immunodeficiency Virus-Exposed Nigerian Infants

Abstract

Background: Despite global achievements in lowering mother-to-child transmission of human immunodeficiency virus, Nigeria still accounts for 14% of the global trend. Therefore, it is imperative to assess prevention of mother-to-child transmission (PMTCT) treatment outcomes and their socio-clinical determinants.

Objectives: To determine the treatment outcomes and socio-clinical predictors of outcomes of HIV-exposed infants.

Methods: The medical records of 409 HIV-exposed infants who received PMTCT care over eight years were assessed. A purpose-designed proforma was used to collect the necessary data, including sociodemographic information, clinical variables, and treatment outcomes: non-infected, infected, and loss to follow-up (LTFU).

Results: Out of the 409 records assessed, 338 (82.64%) infants were non-infected, 12 (2.93%) were infected, and 59 (14.43%) were LTFU. The identified predictors of infection outcomes were the age of first ART clinic attendance (>6 weeks), polygamous family setting, maternal HAART-naïve status, paternal non-awareness of maternal HIV status, and antenatal care outside the tertiary health facility. Other predictors of HIV-infection as an outcome included the gestation age at birth (preterm), mixed-feeding options, non-ART prophylaxis usage, <5 times clinic attendance, low socioeconomic status, and the occurrence of comorbidities like pneumonia.

Conclusions: The HIV infection rate in the cohort was 2.9%. Socio-clinical predictors of treatment outcomes were identified. Health workers and caregivers should pay particular attention to the socio-clinical predictors of infection outcomes to mitigate mother-to-child transmission of HIV.