Prospective study on the prevention of vertical transmission of HIV in Campo Grande, Mato Grosso do Sul, Brazil, from 1996 to 2001

Abstract

This prospective study, involving 76 pregnant women infected with HIV, paired with their 79 exposed infants, was carried out between May 1996 and October 2001, at the Reference Department for Pregnant Women Infected with HIV in Campo Grande, Mato Grosso do Sul. The mean age of the pregnant women was 24 years; 88% (67/76) apparently were infected due to sexual practices; 88% (67/76) were housewives; 823% (63/76) graduated from junior high school; 14.5% (11/76) reported co-infection with Hepatitis C, 9.2% with Syphilis; 51% (39/76) learned the diagnosis during prenatal care; 67% (51/76) reported HIV clinical symptomatology and 9.2% (7/76) reported opportunistic infections. Elective cesareans were performed in 57% (43/76). The mean gestational age at delivery was 38 weeks and we found 12.5% (10/80) pronatis; 97% (74/76) had a ruptured membrane time after less than four hours and one child (1.3%) was nursed. ACTG 076 Protocol (AIDS Clinical Trial Group 076) was used in 80% (61/76) of the pregnant women, with 100% adherence; 62% (38/61) used zidovudine plus another antiretroviral in the gestation; 92% (73/79) of the infants used zidovudine after the birth and 19% (14/73) used zidovudine and lamivudine. The transmission rate in this study was 2.5%.

HIV-1-mother-to-child transmission and associated characteristics in a public maternity unit in Presidente Prudente, Brazil

“…The overall prevalence rate of vertical transmission of HIV-1 in this study was 4.6%. This rate is lower than that found in a nationwide multicenter study (7 In this study, breastfeeding is found to be one of the main risk factors for maternal HIV-1 vertical transmission (Table 1). Infected mothers were advised not to breastfeed their infants and offered clinical or pharmacological support, as recommended by Government Protocol (UNAIDS, 2010).…”

Mother-to-child transmission of HIV in Brazil during the years 2000 and 2001: results of a multi-centric study

“…Other Brazilian authors found similar maternal ages in studies of mother-to-child HIV transmission: 16 to 43 years (median 26.1 years) in the Rio de Janeiro State 17 , 13 to 42 years (median 24 years) in the Mato Grosso State 18 , and 16 to 42 years (median 27.3 years) in the city of Santos, São Paulo State 12 . In Brazil, there has been a stabilizing tendency in the infection rates among women between 13 and 24 years old, with persistent growth in practically all other age groups 1 , and the data observed in this study reflect this increase in the rates among women over 27 years old.…”

“…Some groups of Brazilian authors have shown that, in certain health services and municipalities, the adoption of strategies that increase not only prenatal care, but also offer of a voluntary HIV test, the use of antiretroviral prophylaxis in pregnant women and their infants, in addition to avoidance breastfeeding, have managed to reduce the rates of vertical HIV transmission 9,10,11,12,13,14,17,18,19 . On the other hand, the only multi-centric Brazilian study previously published (evaluating data from health services in the São Paulo State, Brazil, documents the follow-up of 434 children exposed to HIV, born between January 1988 and April 1993) found rates of vertical HIV transmission to be 16% (95%CI: 13.0-20.0) 20 .…”

Mother-to-child transmission of HIV: risk factors and missed opportunities for prevention among pregnant women attending health services in Goiânia, Goiás State, Brazil

“…After the implementation of the prevention measures by the Brazilian Ministry of Health, the rates of vertical transmission have varied between 2.5% and 8.6% in Brazil 17,18,19,20,21,22,23 . These estimates were obtained predominantly from reference centers in the Southeastern Region, and do not necessarily reflect the existing conditions in the majority of healthcare services.…”