Clinical Outcomes and Survival of HIV Exposed Children at 18 Months in Post-Conflict Region: Insight from the Panzi Interdisciplinary PMTCT Cohort (Panzi IPC) study

Background Vertical transmission is the main mode of acquisition of HIV infection in the Democratic Republic of Congo (DRC). We aimed to determine the vital prognosis of infants born to HIV-infected mothers at 18 months after birth in the gynaecology and obstetrics department of the General Hospital of Reference of Panzi (GHRP) in Prevention of mother-to-child transmission of HIV (PMTCT) department. Methods A retrospective cohort of HIV-positive women who delivered and brought their children before and at 18 months of life in the PMTCT/Panzi program during the period from July 1, 2015, to July 1, 2020. Multivariate logistic regression and a Cox proportional hazards model were performed to assess factors associated with positive HIV serology (couple mother-baby) and the risk of HIV MTCT or death at 18 months of life, respectively. Results There were 6318 moms identified, 400 of whom were HIV positive, and had 144 HIV-exposed children. The study found that the prevalence of HIV-infected mothers was 6.3% (400/6318), and the prevalence of vertical HIV transmission was 6.9% (10/144). Premature rupture of the membranes was the most common maternal-foetal complication and was found in 11.1% of cases. Antiretroviral treatment was based on triple therapy (zidovudine (AZT) + lamivudine (3TC) + efavirenz (EFV)) in the majority of cases (77.1%). Logistic regression analysis showed that the risk of HIV was higher in women with no education or primary education, no antenatal care, primiparity, and primigravida. Survival analysis showed that infant death at 18 months was characterized by maternal HIV positivity (HR = 3.93; 95% CI: 1.39–11.10), prematurity (HR = 4.66; 95% CI: 1.41–15.36), and the development of respiratory disease (HR = 5.37; 95% CI: 1.65–17.47). Conclusion The mother-to-child transmission of HIV remains a public health concern in the region, and children born to seropositive mothers have a poor prognosis, including death. The findings highlight the need for intensified interventions to prevent mother-to-child transmission of HIV and improve the health outcomes of children born to HIV-positive mothers.