Abstract:
Background: Pediatric HIV is a leading cause of morbidity and mortality worldwide. The substantial expansion in
PMTCT has generated information on rates of transmission and associated factors, but there are limited studies on disease
progression and mortality in vertically infected children, especially from resource poor settings. Methods: A birth
cohort study was initiated in 2002 to focus on the role of a single dose of nevirapine in HIV transmission before Highly
Active Antiretroviral Therapy (HAART) was readily available. The enrolment of women and subsequent follow up of
the children occurred at 3 peri urban clinics around Harare. Findings: 479 women were HIV infected. From these, 93
(19%) children became HIV infected, 182 (38.0%) uninfected and 204 (43%) lost to follow up before HIV diagnosis.
Of the HIV infected children, 40 (43%) died before the fifth birthday, 26 (28%) were lost to follow up and 27 (29%)
were alive five years after maternal enrolment prior to availability of cART. Conclusion: In this setting, there was unacceptable
high mortality from HIV infected children and loss to follow up prior to availability of HAART. A small
proportion of HIV vertically infected children is surviving in resource poor settings without antiretroviral therapy.
