Immune status and uptake of antiretroviral interventions to prevent mother-to-child transmission of HIV-1 in Africa

The aim of this study performed in Abidjan, Cote d'Ivoire, was to describe the distribution of CD4(+) T-cell lymphocytes (CD4) in HIV-1-infected (HIVE) pregnant women diagnosed during prenatal voluntary counseling and testing and to assess whether HIV-related immunodeficiency influenced the acceptance of an antiretroviral (ARV) package (zidovudine beginning at 36 weeks of amenorrhea plus intrapartum nevirapine) to prevent mother-to-child transmission. Between April and June 2002, a CD4 count was systematically performed in all HIV+ women (n = 22 1) in 5 antenatal clinics carrying out voluntary counseling and testing. No difference in CD4 count was found in HIV+ women who did not return for their test result (n = 50) and those who were informed of their positive serostatus (n = 171) (median CD4 count: 389/mm(3) vs. 420/mm(3); p = 0.19). We also found a lack of difference in CD4 count in those who accepted ARV (n = 72) and those who did not but knew their HIV status (n = 99) (median CD4 count: 405/mm(3) vs. 425/mm(3); P = 0.47). The overall uptake of the intervention (31.9%) appeared to be independent of the maternal immune status.