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Antenatal HIV seroprevalence surveys are important tools to understand the extent of the HIV epidemic in Africa. The main objective is to describe HIV prevalence trends from 1995–2002 in pregnant women consulting antenatal clinics in Abidjan, Côte d'Ivoire. We proposed HIV test to pregnant women consulting antenatal clinics in Abidjan from 1995–2002 in a programme of prevention of mother-to-child transmission of HIV. Yearly prevalence was estimated. Overall, 36,442 women were tested. Prevalence decreased from 14–15% in 1995–96 to 11% in 2002. The prevalence among 18–22-year-old women dropped from 15% in 1995 to 8% in 2002, while for older women it increased slightly, or remained stable from 1995–1999 and decreased thereafter. HIV prevalence among women consulting antenatal clinics has been decreasing overall. This is the first such report among pregnant women in Abidjan, probably the result of different phenomena: ageing of the epidemic and behaviour changes (disease awareness and prevention campaigns). [ABSTRACT FROM AUTHOR]

Background Pregnancy outcomes in women on antiretroviral treatment (ART) in low resource-settings are unknown. We investigate this issue within the Ditrame Plus project and MTCT-Plus Initiative in Abidjan. Methods All HIV-infected pregnant women with at least one delivery and eligible for ART were included. Between March 2001 and July 2003 when ART was not available, they received a short-course antiretroviral regimen (zidovudine (ZDV) + single-dose of nevirapine (sdNVP) or ZDV + lamivudine + sdNVP) (PMTCT Group) and between August 2003 and August 2007, they received a NVP-based ART therapy (ART Group). The following outcomes were studied: low-birth weight (LBW) (<2500 g), stillbirth and neonatal mortality. Women with multiple pregnancies were excluded. Factors associated with LBW were analysed using a logistic regression model. Results Overall, 326 HIV-1 infected women were included: 175 in the PMTCT Group with a median CD4 count 177 cells/ mm³ and 151 initiated ART for at least 28 days before delivery with median CD4 count 182 cells/mm³. Still birth rate was 3.3% in the ART vs 2.9% in the PMTCT group, (p=0.84). The rate of LBW was 22.3% in the ART and 12.4% in the PMTCT group (p=0.02). The multivariate regression model (n=309), ART was associated with LBW when adjusting on the CD4 count, WHO staging, maternal age and maternal body max index (ORa=2.53, p=0.015). The survival at 12 month in HIV-uninfected children was similar between the two groups (Log-Rank test, p=0.78). Neither LBW (ORa=1.5, p=0.38) nor the exposition to ART (ORa=1.1, p=0.85) were associated with infant mortality. Conclusions ART initiated in pregnant women induced low birth weight compared to newborn exposed to PMTCT regimen despite a supplementation with multivitamin in all pregnant women. The proper effect of maternal HAART on child survival needs to be assessed. [ABSTRACT FROM AUTHOR]