Clinical Outcome and HIV Status of HIV-Exposed Babies on Exclusive Breast Feeding and Nevirapine Prophylaxis

Background and objectives: Antiretroviral (ARV) interventions to mother and child, even with breast feeding, can achieve mother to child transmission rates as low as 1%. The present study was done to know the clinical profile, human immunodeficiency virus (HIV) status of the HIV-exposed infants from birth to 6 months of life, and study the benefits of new ARV prophylaxis in infants who are on exclusive breast feeding in reducing the risk of mother to child transmission. Design: Prospective observational study was done at a tertiary care teaching hospital from December 2012 to November 2013. Babies born to HIV-infected mothers at our hospital or referred from outside within 12 h of birth were followed up till 6 months of age. Results: Total numbers of cases enrolled in our study at the end of 6 month follow up period were 21. Of them, 20 were inborn and 1 was out born. Of the 21 cases, 13 (61.9%) were male and 8 (38.1%) were female. Mean birth weight of babies was 2.78±0.43 kg. Most common morbidities at end of 6 months were mild pallor (n=4,19%), fever (n=3,14.29%), upper respiratory tract infection (n=2,9.5%), and splenomegaly (n=2,9.5%). Severe acute malnutrition, hepatomegaly, diarrhoea, oral thrush, microcephaly, and lower respiratory tract infection were seen in 4.8% (n=1). The HIV status was evaluated by DNA PCR at the end of 6 weeks and 6 months and was found to be negative in all the 21 babies. Conclusion: Extended ARV prophylaxis to mothers and infants during the breastfeeding period helps significantly in preventing transmission of the disease. Standardising care of exposed infants, promotion of follow up, feeding counselling, and early detection of infections help to prevent morbidity and mortality.