Evidence map›Paper›PMID 40575633›Full record

ArticleWorld journal of virology2025

Sustained maternal human immunodeficiency virus viral load suppression and cascade of human immunodeficiency virus testing among exposed infants in Rwanda.

Hafidha Mhando Bakari, Jackson Sebeza, Haji Mbwana Ally, Hassan Fredrick Fussi, Habib Omari Ramadhani, Peter Memiah, Djemima Umutesi, Basile Ikuzo, Gallican Rwibasira

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Article in World journal of virology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Hafidha Mhando BakariDepartment of Literature, Communication and Publishing, University of Dar es Salaam, Dar es Salaam 35091, Tanzania.
Jackson SebezaSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda. gallican.rwibasira@rbc.gov.rw.
Haji Mbwana AllyDepartment of Medicine, Kilimanjaro Christian Medical Center, Moshi 3010, Kilimanjaro, Tanzania.
Hassan Fredrick FussiDepartment of Medicine, District Hospital, Dar es Salaam 35091, Tanzania.
Habib Omari RamadhaniDepartment of Medicine, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, United States.
Peter MemiahDepartment of Global Health, Graduate School, University of Maryland, Baltimore, MD 21201, United States.
Djemima UmutesiDivision of Human Immunodeficiency Virus, Rwanda Biomedical Center, Institute of Human Immunodeficiency Virus Disease Prevention and Control, Kigali 4285, Rwanda.
Basile IkuzoDivision of Human Immunodeficiency Virus, Rwanda Biomedical Center, Institute of Human Immunodeficiency Virus Disease Prevention and Control, Kigali 4285, Rwanda.
Gallican RwibasiraDivision of Human Immunodeficiency Virus, Rwanda Biomedical Center, Institute of Human Immunodeficiency Virus Disease Prevention and Control, Kigali 4285, Rwanda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo prevent mother to child transmission (MTCT) of human immunodeficiency virus (HIV), sustained maternal viral load suppression (VLS) and early HIV testing among HIV exposed infants (HEI) is critical.

aimTo investigate maternal viral load results and infant HIV testing uptake at 6-weeks, and 9-months and 18-months in Rwanda.

methodsBetween 2015 and 2022, VLS (< 200 copies/mL) was measured among pregnant women living with HIV (WLHIV) from 38-healthcare facilities. Viral loads (VL) were measured at 6-months, 12-months and 24-months, respectively. For maternal VL, the unit of analysis was visit-pair, and the pairs were created to define those with VL < 200 copies/mL at two consecutive visits as having sustained VLS, persistent viremia (VL ≥ 200 copies/mL at two consecutive visits), viral rebound (VL < 200 copies/mL at prior visit only) and newly suppressed (VL < 200 copies/mL at subsequent visit only). HEI were considered to have persistent HIV testing if they had all three HIV tests. Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio (aIRR) and 95%CI for factors associated with sustained VLS and persistent HIV testing.

resultsA total of 1145 mother-infant pairs were analyzed. Infant HIV testing uptake at 6- weeks, 9-months and 18-months was 1145 (100.0%), 1089 (95.1%), 1006 (87.9%) respectively. Nine hundred ninety-nine HEI (87.3%) tested for HIV persistently. At 18-months, the incidence of HIV among HEI was 8 (0.7%). Of 1145 mothers, 1076 (94.0%) had ≥ 2 VL results making a total of 2010 visit-pairs (142-single; 934-double visit-pairs). The incidence rate of sustained VLS, persistent viremia, viral rebound and new suppression were 91.0%, 1.3%, 3.6% and 4.0% respectively. Maternal disclosure of HIV status (aIRR = 1.08, 95%CI: 1.02-1.14) was associated with increased likelihood of sustained VLS. Having peer support (aIRR = 1.05 95%CI: 1.01-1.10) was associated with persistent HIV testing among HEI.

conclusionSustained VLS is high among pregnant WLHIV in Rwanda. The low incidence of HIV among HEI may be attributed to high VLS levels. Targeted interventions, including enhanced HIV disclosure and peer support, are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.

Indexed as

Human immunodeficiency virus exposed infantsHuman immunodeficiency virus testingMother to child human immunodeficiency virus transmissionRwandaSustained viral load suppressionWomen living with human immunodeficiency virus

Identifiers

PMID40575633
PMCPMC12188896

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.