| Journal: | The brazilian journal of infectious diseases |
| Database: | PERIÓDICA |
| System number: | 000290682 |
| ISSN: | 1413-8670 |
| Authors: | Nogueira, Susie Andries1 Abreu, Thalita Oliveira, Ricardo Araujo, Lucia Costa, Tomaz Andrade, Miriam Psic, M. Fatima Garcia Machado, Elizabeth Rodrigues, Karis Mercadante, Elizabeth Regina Fernandes, Iraina Sapia, M. Conceicao2 Lambert, John S3 |
| Institutions: | 1Universidade Federal do Rio de Janeiro, Servico de Doencas Infecciosas e Parasitarias, Rio de Janeiro. Brasil 2Associacao dos Amigos do Programa de Assistencia Integral a Gestante HIV Positiva, Rio de Janeiro. Brasil 3University of Maryland, Institute of Human Virology, Baltimore, Maryland. Estados Unidos de América |
| Year: | 2001 |
| Season: | Abr |
| Volumen: | 5 |
| Number: | 2 |
| Pages: | 78-86 |
| Country: | Brasil |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Experimental |
| English abstract | 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 women 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 tests between 1 and 4 months of age, or were HIV antibody positive after 18 months. Education regarding infant treatment and use of formula instead of breast feeding was provided. Between 1995 and August, 2000, HIV status was determined for 145 infants. Compliance with intra-partum treatment, infant treatment and use of formula was 88.2%. Intra-partum zidovudine treatment was completed in 134/145 (92.6%) of patients; 88.1% had rupture of membranes < 4 hours; 85.4% 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%; CI: 0.1%-5.4%). The only risk factor significantly associated with transmission was a failure to use zidovudine intra-partum in 2 of the 4 mothers (50% versus 6.4% 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. 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 level of compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants |
| Disciplines: | Medicina |
| Keyword: | Farmacología, Ginecología y obstetricia, Inmunología, VIH, Prevención, Trasmisión perinatal, Zidovudina |
| Keyword: | Medicine, Gynecology and obstetrics, Pharmacology, HIV, Prevention, Perinatal transmission, Zidovudine, Immunology |
| Full text: | Texto completo (Ver HTML) |
