Elimination of Mother-To-Child Transmission of HIV Infection: The Drug Resource Enhancement against AIDS and Malnutrition Model

Abstract

The Drug Resource Enhancement against AIDS and Malnutrition Program (DREAM) gathered professionals in the field of Elimination of HIV-Mother-To-Child Transmission (EMTCT) in Maputo in 2013 to discuss obstacles and solutions for the elimination of HIV vertical transmission in sub-Saharan Africa. During this workshop, the benefits of administrating combined antiretroviral therapy (cART) to HIV positive women from pregnancy throughout breastfeeding were reviewed. cART is capable of reducing vertical transmission to less than 5% at 24 months of age, as well as maternal mortality and infant mortality in both HIV infected and exposed populations to levels similar to those of uninfected individuals. The challenge for programs targeting eMTCT in developing countries is retention in care and treatment adherence. Both are intrinsically related to the model of care. The drop-out from eMTCT programs before cART initiation ranges from 33%–88% while retention rates at 18–24 months are less than 50%. Comprehensive strategies including peer-to-peer education, social support and laboratory monitoring can reduce refusals to less than 5% and attain retention rates approaching 90%. Several components of the model of care for reduction of HIV-1 MTCT are feasible and implementable in scale-up strategies. A review of this model of care for HIV eMTCT is provided.

A five-year review of vertical HIV transmission in a specialized service: cross-sectional study

“…The present study did not allow identification of risk factors [14][15][16][17] This demonstrates the importance of early diagnosis and subsequent treatment in order to reduce the risk factors for vertical transmission.…”

“…One factor that helps reduce the possibility of vertical transmission is the use of medication to inhibit lactation, and 95.9% of the pregnant women in this study were found to be using this medication. 4,8,12,[14][15][16][17][18] Use of antiretroviral drugs during pregnancy increases the The cases of 81.1% of the HIV-positive pregnant women were only notified in the third trimester, thus indicating that there were delays in notification. In Brazil, notification is supposed to occur at the time of detection of HIV infection in pregnant women and/ or children infected by vertical transmission.…”

Percepção Do Familiar Cuidador Acerca Dos Problemas Enfrentados Pela Criança Frente O Diagnóstico De Hiv/Aids

“…Em estudo realizado em hospital sul africano revelou a previdência de doenças como a pneumonia e infecção do trato urinário associados ao HIV, em crianças que necessitaram internação hospitalar (4) . Pesquisa realizada com crianças de Malawi na África demonstrou as múltiplas internações em pacientes com menos de dois anos, essa alta demanda de internações sugere a necessidade de melhoria contínua do diagnóstico precoce (8) .…”

“…Em contextos de recursos limitados, metade das crianças que contraem o HIV de suas mães morre, com destaque para a vulnerabilidade à HIV/AIDS em crianças entre zero a 12 anos e os adolescentes de 13 a 19 anos. No entanto, essas mortes são evitáveis com o diagnóstico precoce, acompanhado de tratamento antirretroviral e profilaxia de infecções oportunistas (4) .…”

Mechanisms and possible controls of the in utero Zika virus infection: Where is the Holy Grail?

“…Other efforts are focused on the invention of antiviral medications effective against the Zika virus. In HIV/AIDS and syphilis, in utero infections are almost completely controlled by effective chemotherapy . We can expect new antiviral medicines to control ZVI in utero.…”