Evaluation of factors associated with vertical HIV‐1 transmission

Rosa, Matheus Costa da; Lobato, Rubens Cáurio; Gonçalves, Carla Vitola; Silva, Naylê Maria Oliveira da; Barral, Maria Fernanda Martínez; Martínez, Ana Maria Barral de; Hora, Vanusa Pousada da

doi:10.1016/j.jpedp.2015.07.021

Cited by 10 publications

(17 citation statements)

References 18 publications

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“…In the northern state of Amazonas, aART completion increased only 10% between 1999 and 2011, with 20% of women not completing ART in 2011 [ 8 ]. A similar situation was shown in the southern state of Rio Grande do Sul, where aART use grew 13% between 1998 and 2011, but over 25% of women still did not complete aART between 2005 and 2011 [ 24 ]. Moreover, a study conducted in the southern state of Paraná found that 16% of women did not complete aART between 2007 and 2012 [ 25 ].…”

Section: Discussionsupporting

confidence: 57%

Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil

et al. 2018

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BackgroundDespite great progress made in methods to prevent mother-to-child transmission of HIV (MTCT), delivery and uptake of these measures remains a challenge in many countries. Although the Brazilian Ministry of Health aimed to eliminate MTCT by 2015, infection still occured in 15–24% of infants born to HIV-infected mothers. We sought to identify remaining factors that constrain MTCT elimination.MethodsWe conducted a retrospective, matched case-control study by reviewing hospital charts of infants born to HIV-infected mothers between 1997 and 2014 at three MTCT reference hospitals in the Rio de Janeiro metropolitan area. Cases were defined as HIV-exposed children with two positive HIV tests before 18 months of age; controls were defined as HIV-exposed children with two negative HIV tests before 18 months of age. We performed bivariate and MTCT cascade analyses to identify risk factors for MTCT and gaps in prevention services.ResultsWe included 435 infants and their mothers (145 cases, 290 controls). Bivariate analyses of MTCT preventative care (PMTCT) indicated that cases were less likely to complete all individual measures in the antenatal, delivery, and postnatal period (p < 0.05). Assessing completion of the PMTCT cascade, the sequential steps of PMTCT interventions, we found inadequate retention in care among both cases and controls, and cases were significantly less likely than controls to continue receiving care throughout the cascade (p < 0.05). Motives for incompletion of PMTCT measures included infrastructural issues, such as HIV test results not being returned, but were most often due to lack of care-seeking. Over the course of the study period, PMTCT completion improved, although it remained below the 95% target for antenatal care, HIV testing, and antenatal ART set by the WHO. Adding concern, evaluation of co-infections indicated that case infants were also more likely to have congenital syphilis (OR: 4.29; 95% CI: 1.66 to 11.11).ConclusionsWhile PMTCT coverage has improved over the years, completion of services remains insufficient. Along with interventions to promote care-seeking behaviour, increased infrastructural support for PMTCT services is needed to meet the HIV MTCT elimination goal in Brazil as well as address rising national rates of congenital syphilis.

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Section: Discussionsupporting

confidence: 57%

Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil

et al. 2018

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“…According to these authors, the increase of HAART use during pregnancy, the reduction of the maternal VL and an interval lower than 4 hours between the rupture of the membranes and birth were the factors that were associated with VT reduction. 22 Barral et al, 23 analyzing the results of 262 pairs of mothers and children from 2003 to 2007, found a VT rate of 3.8%. Two risk factors significantly contributed for maternal-fetal transmission, according to these authors: no use of HAART by pregnant women, and non-adherence to prenatal care at referral service.…”

Section: Discussionmentioning

confidence: 99%

Vertical Transmission of HIV-1 in the Metropolitan Area of Belo Horizonte, Brazil: 2006–2014

Melo

Maia

Corrêa

et al. 2017

Rev Bras Ginecol Obstet

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“…Preventing MTCT and ensuring the survival and well-being of women with the infection contribute directly to achieving one of the Sustainable Development Goals 2 . Although HIV infection is in the process of stabilization, it still presents high transmission rates, especially in women 3 .…”

Section: Introductionmentioning

confidence: 99%

Vertical transmission of HIV from 2007 to 2018 in a reference university hospital in Rio de Janeiro

Gouvêa

Trajano

Monteiro

et al. 2020

Rev. Inst. Med. trop. S. Paulo

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Evaluation of factors associated with vertical HIV‐1 transmission

Cited by 10 publications

References 18 publications

Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil

Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil

Vertical Transmission of HIV-1 in the Metropolitan Area of Belo Horizonte, Brazil: 2006–2014

Vertical transmission of HIV from 2007 to 2018 in a reference university hospital in Rio de Janeiro

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