Abstract
INTRODUCTION: Screening and surveillance of HIV-positive pregnant women remain major public health challenges in the Democratic Republic of the Congo (DRC). This study aimed to describe the epidemiological, clinical, and biological characteristics of HIV-positive pregnant women in South Kivu. METHODS: A retrospective cohort study was conducted at Panzi Hospital from July 2015 to July 2020. Multivariate logistic regression analyses were performed to identify factors associated with HIV status. RESULTS: Among the 9,143 women enrolled in PMTCT, 6,318 were tested, of whom 256 (4.1%) were HIV-positive, including 112 pregnant women (1.8%). Compared with their HIV-negative counterparts, HIV-positive pregnant women had lower antenatal care attendance compared with HIV-negative counterparts. The main opportunistic infections were candidiasis and genital herpes (2.7% each). Only 58% had available CD4 counts, all above 500 cells/ml. An undetectable viral load (< 30copies/l) was recorded in 60.7% of cases. Liver and renal dysfunctions were observed in 6.2% and 30.3% of patients, respectively, wereas d anemia (< 12 g/dl) affected 61.6%. In multivariable analysis, HIV infection was associated with age < 20 years (aOR = 7.20), primary education (aOR = 5.30), household income of $50-100/month (aOR = 56.4), primiparity (aOR = 10.68), and poverty (aOR = 18). Conversely, multigravidity (aOR = 0.19) and residence in the Ibanda and Kadutu health zones were protective factors CONCLUSION: Epidemiological and biological profiles strongly influence PMTCT outcomes. Strengthening HIV testing, expanding ART access, and routine viral load monitoring particularly among young and primiparous women are essential to improve maternal and neonatal health outcomes in the DRC.