Joao EC, Cruz ML, Bazin G, Calvet G, Salgado L, d'Ippolito M, Silva S, Menezes J, Matos H; Conference on Retroviruses and Opportunistic Infections.
9th Conf Retrovir Oppor Infect Feb 24 28 2002 Wash State Conv Trade Cent Seattle Wash Conf Retrovir Oppor Infect 9th 2002 Seattle Wash. 2002 Feb 24-28; 9: abstract no. 790-W.
Hosp. Servidores do Estado, Rio de Janeiro, Brazil
BACKGROUND: Little is known about vertical transmission rates and effectiveness of ARV prophylaxis/therapy in Brazil although local authorities provide free prenatal testing, ARV drugs, and formula.METHODS: Women were included when: HIV infection was confirmed, they had at least 3 prenatal visits, and 6 months post-delivery follow-up. Data were collected from 306 women from January 1, 1996 through June 30, 2001, of which 14 had repeat (2) pregnancies and 259 children had their HIV-infection status defined either by PCR-DNA or viral load at > 4 months or serology at > 18 months in at least 2 blood samples. Mean age at entry was 27. Only 33 women (12.7%) were in their first pregnancy, and 53% had low educational level. No child was breastfed. The following data were analyzed: CD4, viral load, ARV usage, mode of delivery, birth weight, prematurity, time of ruptured membranes, and transmission rate.RESULTS: 320 pregnant women were included in the cohort up to June 2001. 10 children presented diagnostic criteria for HIV infection, 249 were considered free of infection, 26 are still under investigation, 9 died before diagnosis, 5 of which were stillbirths, and 26 were lost to follow-up. The best estimate for the incidence rate of HIV infection in children was 3.859%. The results of the unconditional logistic regression showed that the main variables associated with vertical transmission were: low birth weight (< 2500 g), (OR=3.75); premature birth, with a cutoff of 37 weeks (OR=2.81), and mode of delivery (OR of 2.26 for vaginal delivery in comparison with elective C-section). Maternal CD4 counts, viral load, and time of membrane rupture were not associated with transmission, due to the homogeneous distribution in infected and non-infected children. All analyses were performed using SPSS version 9 software.CONCLUSIONS:This study confirms published data on the prevention of vertical transmission of HIV. Taking into account the characteristics of this cohort, the incidence rate is satisfactory, but we are working to reduce it further, and hope the above data will help us and others implement better preventive measures to be adopted in mid-developed countries.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Brazil
- CD4 Lymphocyte Count
- Child
- Disease Transmission, Vertical
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Incidence
- Pregnancy
- Stillbirth
- Viral Load
- transmission
Other ID:
UI: 102263654
From Meeting Abstracts