Clinical and biological risk factors influencing infant HIV status: a case study of Kisenyi Health Center IV, Kampala, Uganda

Abstract

Transmission of HIV from mother to child (MTCT) contributes to 18% of new HIV infections in Uganda. This study aimed at investigating how clinical and biological risk factors were associated with the transmission of HIV from mothers to children in Uganda. This study utilized secondary data extracted from patient charts of 200 mothers living with HIV and their children who received services at Kisenyi Health Centre IV between 2017 and 2022. To model the relationship between the independent factors and the child’s HIV status, the Probit regression model was used. Among the children, 22.5% were living with HIV. The type of antiretroviral (ARV) regimen administered to the mother significantly influenced the child’s HIV status. Specifically, the AZT/3TC/NVP regimen (Zidovudine, Lamivudine, Nevirapine) was associated with a statistically significant increase in the odds of HIV positivity in children (OR = 5.12; p = 0.016). Children whose mothers received the ABC/3TC/LPV regimen had 2.49 times higher odds of living with HIV compared to those on regimen TDF/3TC/EFV (p = 0.017). Additionally, maternal HIV viral load was a significant biological determinant of the child’s HIV status. A viral load above 1000 copies/mL was associated with a fivefold increase in the odds of the child living with HIV (OR = 5.06; p < 0.001). These findings highlight the importance of clinical decision-making, particularly the choice of ARV regimen, and the monitoring of maternal HIV viral load during pregnancy to optimize the likelihood of delivering an HIV-negative child. The study further recommends that future research and targeted interventions build on these results to improve HIV treatment outcomes in pediatric populations.