High vertical HIV transmission rate in the Midwest region of Brazil

Matos, Vanessa Terezinha Gubert de; Batista, Fabiani de Morais; Versage, Naiara Valera; Pinto, Clarice Souza; Oliveira, Vanessa Marcon de; Vasconcelos-Pereira, Erica Freire; Matos, Roberta Barbeta dos Rios de; Fabbro, Márcia Maria Ferrairo Janini Dal; Oliveira, Ana Lúcia Lyrio de

doi:10.1016/j.bjid.2018.04.002

Cited by 4 publications

(10 citation statements)

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“…A survey conducted at Campo Grande in the Midwest Region of Brazil, between 2007 and 2013, found HIV MTCT rate of 8.7%, and approximately one-third of these mothers did not receive any prenatal care which increased the chance of MTCT by 13.9 times. 21 The percentage of mothers of infected children who received no prenatal care was similar in the present study, and a lack of prenatal care was considered a risk factor for increased MTCT. Other studies have also found an association between increased MTCT and no prenatal care 16,[22][23][24][25] The importance of administering ART during pregnancy has been known for some decades, and currently, with combined therapy, HIV MTCT rates have become significantly lower.…”

Section: Discussionsupporting

confidence: 77%

“…These same results have also been found in other studies. 19,21,22,24,25,27 Another previously established risk factor was coinfection with syphilis or other sexually transmitted infections during pregnancy, which would facilitate HIV MTCT by various means. 28 Infections with these organisms can lead to cervicitis, which could trigger increased viral dissemination of HIV in the cervicovaginal region, 29,30 as well as placental inflammation, 31,32 increasing the VL of HIV and decreasing the amount of maternal CD4.…”

Section: Discussionmentioning

confidence: 99%

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Mother-to-Child HIV Transmission among Pregnant Women in a City with the Highest Rates of HIV in Brazil

et al. 2021

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Objective Most of the HIV pediatric infections are acquired through mother-to-child transmission (MTCT). Porto Alegre is a state capital of Brazil that had a HIV MTCT rate of 4.1% in 2013 and the highest rate of HIV-infected pregnant women in the country during 2018. Zidovudine and nevirapine have been used in Brazil for high-risk newborns since 2012. The aim of the study was to investigate HIV MTCT rate and the factors associated with HIV transmission at a hospital that is a reference center for HIV-infected mothers in Porto Alegre, after the introduction of this policy. Study Design This retrospective cohort study included all HIV-exposed infants born between February 2013 and December 2016 at the Hospital de Clínicas de Porto Alegre. Student's t-test or Fisher's exact test was used to compare variables between HIV-infected and uninfected groups of newborns. Poisson's regression with robust variance was used to determine the factors associated with HIV MTCT. Results A total of 375 newborns were exposed to HIV, with an outpatient loss of 14.4% (n = 54). The HIV MTCT rate was 2.18% (n = 7), with four infected during the intrauterine period. The risk factors for MTCT were no prenatal care (relative risk [RR] = 9.4; 95% confidence interval [CI]: 2.0–44.3), late maternal HIV diagnosis in the peripartum period (RR = 16.3; 95% CI: 3.6–73.0), syphilis infection during pregnancy (RR = 9.3; 95% CI: 2.1–40.3), maternal viral load >1,000 copies/mL in the third trimester or peripartum period (RR = 9.5; 95% CI: 1.7–50.5), and lack of or inappropriate antiretroviral therapy during pregnancy (RR = 8.2; 95% CI: 1.6–41.4). Conclusion MTCT rate was 2.18%. With the institution of two-drug prophylaxis for high-risk newborns, persistent cases HIV MTCT were predominantly found among women with absence of antenatal care, late HIV diagnosis, syphilis coinfection, high viral load, and inadequate ARV therapy during pregnancy. Although zidovudine and nevirapine were administered postnatally to high-risk newborns, this regimen could not prevent transplacental transmission. Key Points

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Mother-to-Child HIV Transmission among Pregnant Women in a City with the Highest Rates of HIV in Brazil

et al. 2021

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“…Thus, the vertical transmission rate found is far from that recommended by the Ministry of Health, which is 2% 12 . It is also higher than the rate of 6.3% found in Itajai city 22 , the municipality in Brazil with the highest rate of HIV detection in children aged ≤ 5 years 19 , 23 .…”

Section: Discussionmentioning

confidence: 66%

Vertical transmission of HIV to neonates in a reference hospital in Northeastern Brazil from 2013 to 2017

Figueredo,

Monteiro,

Batista

et al. 2023

Rev. Inst. Med. trop. S. Paulo

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The aim of this study was to estimate the rate of Mother-to-child Transmission (MTCT) of HIV to neonates in a reference university hospital in Sao Luis city, the capital of Maranhao State (MA), evaluating MTCT-associated factors. A retrospective cohort study based on data from the Notifiable Diseases Data System (SINAN) was carried out and included all HIV-exposed neonates notified from 2013 to 2017 by the university hospital. The study population comprised 725 HIV-exposed neonates, of whom 672 neonates were exposed and uninfected, and 53 were exposed and infected. The estimated rate of MTCT in the period of 2013 to 2017 was 7.3%. Most pregnant women were ≥ 20 years old (86.9%), reported ≥ 8 years of schooling (53.2%), reported full-time or independent paid work (46.9%) and were residents in other cities of the state (61.7%). Regarding healthcare, 86.3% received prenatal care, 74.6% received Antiretroviral Therapy (ART) as prophylaxis during pregnancy, 81.8% received ART prophylaxis during childbirth and 78.1% underwent cesarean section. Among the neonates, 92.8% received ART prophylaxis and 94.3% were not breastfed. Despite these variables, the 7.3% MTCT rate found in this study makes it clear that the interventions recommended by the Ministry of Health were not fully adopted.

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“…Brazilian Journal of Health Review, Curitiba, v.4, n.5, p. 21049-21059 sep./oct. 2021 Desde o seu início, a infecção passa por um processo de estabilização, contudo as taxas de infecção têm aumentado na população feminina, o que é chamado de feminização da doença. Este processo é de suma importância, visto que o aumento da infecção entre mulheres em idade fértil pode ocasionar o aumento de crianças expostas ao vírus devido a transmissão vertical (TV) do HIV, que pode ocorrer durante a gestação, parto ou durante a amamentação (MEIRELLES;LOPES;LIMA, 2016).…”

Section: Introductionunclassified

Perfil epidemiológico da transmissão vertical de HIV no Brasil/ Epidemiological profile of vertical HIV transmission in Brazil

Costa¹,

Souza²,

Azevedo³

et al. 2021

Braz. J. Hea. Rev.

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A transmissão vertical é a principal causa de infecção do HIV em crianças. Diante deste cenário, este estudo visa traçar o perfil epidemiológico da transmissão vertical do HIV no Brasil. METODOLOGIA: Realizou-se uma revisão integrativa com busca em bases de dados nacionais e internacionais. De acordo com os critérios de inclusão e exclusão, os artigos foram selecionados para composição do trabalho. RESULTADOS: Os artigos foram publicados em periódicos nacionais e internacionais, entre os anos de 2016 e 2021. Foram 20 artigos previamente selecionados, compondo os referenciais teóricos obtidos na busca bibliográfica para este estudo. DISCUSSÃO: No Brasil, houve diminuição da taxa de transmissão vertical do HIV entre 1996 e 2016, chegando a 5 casos a cada 100.000 nascidos vivos. Porém, ainda continuam muitas barreiras para a eliminação completa da TV. O período de maior vulnerabilidade é o terceiro trimestre e o parto, sendo que a TARV e profilaxias adequadas poderiam diminuir substancialmente a transmissão às crianças expostas. CONCLUSÃO: Para modificar o cenário atual, é prioritário o incentivo à assistência materno-infantil e às redes de cuidado da pessoa vivendo com HIV, lembrando do seguimento do recém-nascido exposto e do fornecimento de leite substituto.

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High vertical HIV transmission rate in the Midwest region of Brazil

Abstract: The vertical HIV transmission rate has increased over the years and the recommended interventions have not been fully adopted. HIV-infected pregnant women need adequate prophylactic measures in prenatal, intrapartum and postpartum, requiring greater integration among health professionals.

Cited by 4 publications

References 24 publications

Mother-to-Child HIV Transmission among Pregnant Women in a City with the Highest Rates of HIV in Brazil

Mother-to-Child HIV Transmission among Pregnant Women in a City with the Highest Rates of HIV in Brazil

Vertical transmission of HIV to neonates in a reference hospital in Northeastern Brazil from 2013 to 2017

Perfil epidemiológico da transmissão vertical de HIV no Brasil/ Epidemiological profile of vertical HIV transmission in Brazil

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