Evolución de la transmisión vertical de la infección por virus de inmunodeficiencia humana en Chile

Abstract

The identification of various risk factors of vertical human immunodeficiency virus (HIV) transmission resulted in the development of strategies whose aim was to decrease the mother's viral load, to reduce her child's exposure to it during delivery, and to avoid the subsequent viral exposure due to breastfeeding. The administration of antiretroviral treatment during pregnancy, delivery and to the neonate (PACTG 076) proved to be useful. At a first stage, zidovudine was used. A triple combination therapy was then administered. Initially, the viral transmission in mothers who were enrolled in protocols for vertically transmitted HIV prophylaxis was reduced to 9.5%, whereas the last measurement carried out between 1998 and 2005, the initial figure was brought down to 2%. Nevertheless, the delivery of infected children whose mother's HIV status was unknown is still considered likely to happen. The main step to be taken to reduce HIV infection among children is to perform universal HIV tests during pregnancy, so that HIV positive pregnant patients conveniently receive proper prophylaxis. We look forward to achieving this by following the new prevention guidelines of vertically-transmitted HIV infection, developed by the Comisión Nacional del SIDA of the Chilean Health Ministry.

Digestive, Hepatic, and Nutritional Manifestations in Latin American Children With HIV/AIDS

“…In Cuba in 2004 there were 291 infected or affected children between 9 and 14 years old (9). In Chile the Pediatric National AIDS Committee registered in September 2004 a total of 871 accumulated cases of children exposed to vertical transmission, 213 of whom had HIV infection (24.5%) (10), with a female tendency toward epidemics; at the end of 2005, 20% to 30% cases of HIV/ AIDS infections were in women, mainly at the age of procreation, acquired in 95% of cases by heterosexual transmission (11), with a 2% reduction in vertical transmission (12). In Uruguay, the prevalence rate of the disease is increasing: in 2004 it was 0.45% of the total population, with a vertical transmission rate of 2.5% in 2003, and perinatal transmission of 1.6% in October 2005 (13).…”

Prevención de la transmisión vertical y efectos secundarios de la terapia anti-retroviral en hijos nacidos de madres seropositivas para VIH en el área Sur-Oriente de Santiago, Chile: perspectiva de 15 años

“…Independientemente de la cifra, esta vía de infección es responsable de 92% de las infecciones en niños 3 . A nivel nacional, la prevención de la TV se aplica desde el año 1997, inicialmente como monoterapia con zidovudina tanto a la madre como al recién nacido y posteriormente con bi y triterapia, según los nuevos protocolos, lo que ha permitido que la tasa de TV en binomios madre-hijo controlados disminuyera de 30% hasta 1996 a 1,6% en el año 2010 2,4,5 . A pesar del evidente beneficio de la terapia anti-retroviral (TARV), ésta no está exenta de efectos adversos tanto en los recién nacidos como en las mujeres embarazadas.…”