Assessment of mother-to-child HIV prevention program in Albania

Abstract

Aim: Mother-to-child transmission (MTCT) is one of the recognized routes of HIV transmission. This study aims to assess MCTC among HIV positive pregnant women in Albania.

Methods: This was a retrospective study that included a case series of 14 pregnant women in Albania diagnosed with HIV between 2014 and 2020 who were enrolled in HIV care ambulatory centre. The following variables were analysed: epidemiological characteristics (age, HIV diagnoses in regard to pregnancy), clinical characteristics such as use of antiretrovirals, adherence to treatment, CD4 cell count, viral loads, mode of delivery, gestational age at delivery) and the HIV status of the infant. Descriptive statistics were used to summarise the variables in the data sample.

Results: Eight women (57.2%) were aware of their HIV status prior to the pregnancy, while for the other 6 women (42.8%) an HIV diagnosis was done during the pregnancy as part of the antenatal testing. Only two women (14.28%) had a viral load of >1000 copies/ml before delivery. The mean time from diagnosis to initiation of antiretroviral therapy was 3.83 weeks +2.4 SD (range 1-7 weeks). Adherence was calculated to be good, with 92.9% of women reporting taking the medication precisely as directed. No mother to child transmission cases were reported among the women in our cohort.

Conclusion: Gaps in prenatal screening for HIV and viral load measurements were identified in this study conducted in Albania. Thus, educating the providers, in this case the obstetricians, to offer first trimester HIV screening to all pregnant woman and to enhance testing, would reduce vertical transmission.