Mother-to-child transmission of HIV infection in Manaus, State of Amazonas, Brazil

Abstract

<jats:p>INTRODUCTION: Reduction in the vertical transmission of HIV is possible when prophylactic measures are implemented. Our objective was to determine demographic characteristics of HIV-infected pregnant women and the rate of mother-to-child transmission of HIV in Manaus, Amazonas, Brazil. METHODS: A descriptive study was conducted using notification, and investigating data from the Notifiable Diseases Data System in the Brazilian State of Amazonas, between 2007 and 2009. RESULTS: During the study period, notification was received of 509 HIV-positive pregnant women. The vertical transmission was 9.9% (95% CI: 7.2-12.6%). The mean age of women was 27 years (SD: 5.7), and the majority (54.8%) had not completed elementary school (eighth grade). Diagnosis of HIV seropositivity was made prior to pregnancy in 115 (22.6%) women, during prenatal care in 302 (59.3%), during delivery in 70 (13.8%), and following delivery in 22 (4.3%). Four hundred four of these women (79.4%) had had prenatal care, with 79.4% of patients receiving antiretroviral during pregnancy and 61.9% of the newborn infants receiving prophylaxis. In the final multivariate logistic regression model, living in urban area [OR = 0.7 (95% CI: 0.35-0.89)] and having had prenatal care [OR = 0.1 (95% CI: 0.04-0.24)] remained as protective factors against vertical HIV transmission in this population. CONCLUSIONS: The relevance of adequate compliance with the measures already established as being effective in guaranteeing a reduction in HIV transmission within the maternal and infant population should be emphasized.</jats:p>

Prenatal testing and prevalence of HIV infection during pregnancy: data from the “Birth in Brazil” study, a national hospital-based study

“…This proportion was higher than that observed in the Sentinel Parturient Study of 2006 [4], when 62.8% of the pregnant women analyzed presented with an HIV serological test. Our results thus corroborate the findings from recent local studies [13,18,19,23,24], which indicated coverage close to 80%. Although a notable increase in this coverage was seen, regional differences were still observed.…”

“…The decline in mortality due to AIDS in Brazil since the 2000s [3], with increasing survival among HIV-infected individuals [46,47], is one possible explanation. The high proportion of pregnant women with diagnoses of HIV infection prior to the current pregnancy, which has been reported in several national studies [11,13,14,18,19], suggests that women who have been infected for longer periods are becoming pregnant, which may also explain the increase in prevalence with age.…”

“…Local studies conducted in the Southeast region [11-14] have reported vertical transmission rates closer to 3%, while rates of less than or equal to 2% have been found in the Midwest and South regions [15-17]. In contrast, in the North and Northeast regions and in the state of São Paulo, local studies have found vertical transmission rates of 9.9% [18], 9.2% [19] and 6.0% [20], respectively.…”

“…Local studies [13,15,18,19,23,24] have indicated that the coverage of HIV testing has increased in all Brazilian regions. However, these results were from studies with municipal or state coverage while no studies with national coverage that could adequately provide estimates for the country have been conducted recently.…”

Late diagnosis and HIV infection in children attending a service of specialized care for pediatric AIDS in Brazil

“…Some studies conducted in Brazil assessing the frequency of MTCT differed in the rates of infection in children, with the incidence ranging from 2.8 to 9.9% [8][9][10][11][12][13] . Despite the free access to ART in Brazil, MTCT is not under control.…”