Objective: To study the delivery outcomes and complications associated with human immunodeficiency virus (HIV) positive women. Patients and Methods: A clinical audit from January 2006 to December 2009 involving patients accessing antenatal and delivery services at the Korle-Bu Teaching Hospital and using the voluntary counseling and testing/prevention of mother-to-child transmission services. Results:. HIV-positive women on the highly active antiretroviral therapy and ART prophylaxis had a mean CD4 count of 681 cells/ul (range: 412–810). Those who were not on any prophylaxis had a mean count of 288 cells/ul (range: 34–601). The study and comparison populations had similar mean ages; 29.8 years and 28.4 years, respectively (P = 0.09). About half the HIV-positive women had vaginal delivery though none had an episiotomy, forceps, or vacuum delivery. The HIV-positive women had a caesarean section rate of 55% and the rate in the HIV-negative women was 21% (P < 0.001). About 50% of the caesarean deliveries were done as emergencies. The mean birth weight was lower in the HIV-positive women; 2.9 kg versus 3.1 kg, respectively (P = 0.08). The perinatal losses were significantly higher in the study population; 95 versus 70 (P = 0.04). The mean placenta weight was smaller in the study population; 510 g versus 550 g (P = 0.04). Conclusion: Among the HIV-positive parturient, the caesarean delivery rate was about 50% and the neonatal outcomes were significantly worse than in the HIV-negative women.

Aim: The aim of this study is to evaluate the effectiveness of prevention of mother-to-child transmission (PMTCT) of HIV program in a tertiary level health facility in Abuja, Nigeria. Materials and Methods: It was a retrospective study. Records of HIV positive pregnant women who registered and had antenatal care (ANC) in the period January 1, 2006 to December 31, 2008, delivered in the hospital and whose HIV-exposed babies were followed-up to 6 weeks of age when HIV status was determined by DNA polymerase chain reaction techniques were collected and analyzed. Results: During the 3 years period, 643 pregnant women were HIV-positive. Among these group, 495 delivered in the hospital and 247 had their babies followed-up till the point of HIV testing. The overall MTCT rate was 2.4%, mothers who used triple combination antiretroviral (ARV) therapy or prophylaxis recorded MTCT rate of 1.3% while mothers who received only intrapartum single dose nevirapine had MTCT rate of 37.5%. The majority of the mothers, 186 (76.5%) were delivered by caesarean section, and the MTCT rate in this group was 1.6% while the MTCT rate in mothers who delivered vaginally was 5.5%. Exclusive formula feeding was practiced by 232 (96%) mothers, and had a MTCT rate of 2.1%. While the MTCT rate in mothers who practiced exclusive breastfeeding was 12.5%. Conclusions: The MTCT rate in the PMTCT program in this study compared favorably with reports from other centers and developed countries where similar interventions are the standard care for HIV-positive women. The finding demonstrates that routine provision of comprehensive PMTCT services including triple combination ARV drugs is feasible and effective in our setting.

Background: Integrating routine HIV counseling and testing as a mandatory part of antenatal care in India has led all pregnant women enter into the prevention of mother to child transmission (PMTCT) of HIV program. Despite such strategies, the effective execution and uptake of these programs remains a major obstacle. It is thus, important to understand the experiences of pregnant women undergoing HIV testing to detect the flaws on the part of the provider and the benefiter and eliminate them to strengthen the PMTCT services. Aim: We studied the acceptability of HIV voluntary counseling and testing (VCT) in antenatal women attending a tertiary health center of the North India. The impact of the sociodemographic factors on HIV prevalence and uptake of PMTCT was also studied, and the possible reasons for dropouts were determined. Methods: Pretest counseling was performed, and sociodemographic data and blood samples were collected from the consenting antenatal pregnant women. Samples were tested for HIV antibodies as per the World Health Organization guidelines. Data were analyzed and presented as mean, percentages, and tables. Results: Of 30,150 pregnant women counseled, 23,464 (77.82%) underwent testing. 136/23,464 women tested seropositive. The prevalence of HIV in antenatal women was found to be 0.58%. The majority of these women were young and belonged to the age group 20–24 years (0.23%). 22% refused testing, the reasons for which were sought. Strong associations were found between the HIV seroreactive status and marital status, low education status, low social class, high parity, and unemployment. Conclusion: To eliminate pediatric transmission of HIV and to create more awareness regarding HIV infection and MTCT, there is a need to make VCT and PMTCT programs more acceptable to the population. The observations found in the study were consistent with the national projections.

A pancreatic tuberculous abscess is extremely rare, considered to be an AIDS-defining illness in HIV-positive patients. It is even rare to present as an initial manifestation of AIDS. We present a case that presented with epigastric pain, fever, and reduced appetite. The cystic pancreatic lesion was identified and computed tomography-guided fine needle aspiration proved it to be a tuberculous abscess, confirmed by demonstration of acid fact bacilli in the pus aspirated. Although rare, it must be considered in the differentials in HIV-positive patients and can be confirmed by minimally invasive image-guided aspiration with microbiological or histopathological evaluation. Etiopathogenesis, presentation, and review of the literature is been summarized.