Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach
Braz. j. infect. dis
;
5(2): 78-86, Apr. 2001. tab
Artigo
em Inglês
| LILACS
| ID: lil-301188
RESUMO
Objectives:
To determine the HIV vertical transmission rate (VTR) and associated risk factors by use of zidovudine and infant care education in Brazil.Methods:
Since 1995, a prospective cohort of HIV infected pregnant womwn has been followed at the Federal University of Rio de Janeiro. A multidisciplinary team was established to implement the best available strategy to prevent maternal-infant HIV transmission. Patients with AIDS or low CD4 and high viral load received anti-retroviral drugs in addition to zidovudine. Children were considered infected if they had 2 positive PCR-RNA test between 1 and 4 months of age, or were HIV antibody positive after 18 months. Education regarding infant treatment and use of formula insteadof breast feeding was provided.Results:
Between 199 and August, 2000. HIV status was determined for 145 infants. Compliance with intra-partum treatment, infant treatment and use of formula was 88.2 percent. Intra-partum zidovudine treatment was completed in 134/145 (92.6 percent) of patients; 88.1 percent had rupture of membranes < 4 hours; 85.4 percent of mothers were asymptomatic. The mean CD4 count was 428,4 cells and mean viral load 39,050 copies. HIV vertical transmission rate was 4/145 (2.75 percent; CI 0.1 percent - 5.4 percent). The only risk factor significantly associated with transmission was a failure to use zidovudine intra-partum in 2 of the 4 mothers (50 percent versus 6.4 percent in non-transmitting mothers). A trend toward low CD4 and high viral load at entry, and rupture of membranes > 4 hours were associated with increased HIV transmission.Conclusion:
HIV vertical transmission in Brazil was reduced to a level similar to other countries with the most effective prevention programs using a multidisciplinary team approach. A high levelof compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Equipe de Assistência ao Paciente
/
Zidovudina
/
Síndrome da Imunodeficiência Adquirida
/
HIV-1
/
Transmissão Vertical de Doenças Infecciosas
Tipo de estudo:
Estudo de etiologia
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Recém-Nascido
/
Gravidez
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Assunto da revista:
Doenças Transmissíveis
Ano de publicação:
2001
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Estados Unidos
Instituição/País de afiliação:
Federal Universiy of Rio de Janeiro/BR
/
University of Maryland/US
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