ABSTRACT
UNLABELLED: The prevention of vertical transmission (VT) of human immunodeficiency virus (HIV) is a priority as it generally is an avoidable disease. AIM: To describe Uruguay's experience of VT during 23 years and the preventive measures adopted. PATIENTS AND METHODS: Children of HIV positive mothers born between January 1987 and December 2009 were followed. The mother, pregnancy and children dependent variables were analysed. Infants were classified as infected, not infected, exposed but still in evaluation, or withdrawn of the protocol. The different measures implemented were analyzed. RESULTS: There were 1353 children of HIV positive mothers; 204 (15.1%) infants were infected. The percentage of VT diminished throughout the years; between 2003 and 2009 it decreased to 6%. Protective factors against HIV VT were antiretroviral therapy (ARV) during pregnancy, elective caesarean section and not to nurse the newborn infant. Women who did not receive AlRV had a percentage of VT of 50.3 %. CONCLUSION: The VT has diminished in Uruguay. Special efforts must be done to screen all pregnant women, to improve diagnosis during pregnancy and to implement suitable ARV as occurs in developed countries.
Subject(s)
HIV Infections/transmission , HIV-1 , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/prevention & control , Breast Feeding , Cesarean Section , Contraindications , Female , HIV Infections/epidemiology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Retrospective Studies , Uruguay/epidemiologyABSTRACT
The prevention of vertical transmission (VT) of human immunodeficiency virus (HIV) is a priority as it generally is an avoidable disease. Aim: To describe Uruguay's experience of VT during 23 years and the preventive measures adopted. Patients and Methods: Children of HIV positive mothers born between January 1987 and December 2009 were followed. The mother, pregnancy and children dependent variables were analysed. Infants were classified as infected, not infected, exposed but still in evaluation, or withdrawn of the protocol. The different measures implemented were analyzed. Results: There were 1353 children of HIV positive mothers; 204 (15.1%) infants were infected. The percentage of VT diminished throughout the years; between 2003 and 2009 it decreased to 6%. Protective factors against HIV VT were antiretroviral therapy (ARV) during pregnancy, elective caesarean section and not to nurse the newborn infant. Women who did not receive AlRV had a percentage of VT of 50.3 %. Conclusion: The VT has diminished in Uruguay. Special efforts must be done to screen all pregnant women, to improve diagnosis during pregnancy and to implement suitable ARV as occurs in developed countries.
Introducción: La prevención de la transmisión materno infantil (TMI) del VIH es una prioridad debido a que está demostrado que es una infección prácticamente evitable. Objetivo: Presentar cifras de TMI durante 23 años junto a las distintas medidas adoptadas. Pacientes y Métodos: Hijos de madre con infección por VIH nacidos entre el 1/I/1987 y el 31/XII/2009. Se estudiaron variables con respecto a la madre, el embarazo y el niño. Se clasificaron a los niños en infectados, no infectados y expuestos sin clasificar por estudio pendiente o abandono del protocolo. Se analizaron las acciones implementadas. Resultados: Hubo 1.353 hijos de madre infectadas por VIH; se excluyó 1. Resultaron 204 infectados (15,1%). El porcentaje de TMI disminuyó a lo largo de los años; entre 2003 y 2009 y en el último período llegó a 6%. Fueron factores protectores para disminuir la TMI el haber recibido terapia antiretroviral (TARV) durante el embarazo, no amamantar y la cesárea electiva. Las mujeres que no recibieron TARV tuvieron un porcentaje de TMI de 50,3%: Discusión: La TMI ha disminuido en Uruguay. Se deben realizar esfuerzos para captar la mujer embarazada, diagnosticarla y ofrecer TAlRV adecuado para lograr cifras similares a la de países desarrollados.