Risk Factors of Hiv-1 Vertical Transmission (Vt) and the Influence of Antiretroviral Therapy (Art) in Pregnancy Outcome

Abstract

In the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.

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

“…In Israel, after the implementation of ART in the national recommendations, there was a reduction in MTCT from 16.3% to 1.7% 29 . At the national level, several authors have confirmed this association 18,20,21 . Although the MTCT has decreased over the study period, the authors cannot affirm whether there is a correlation, because the use of ARV was not available in all medical records.…”

Hepatitis C Sentinel Seroprevalence, Cape Coast, Ghana

“…The explanation for these variations could be due to differences in geographical patterns and varying physician test ordering practices, care-seeking and disclosure behaviors of pregnant women, or factors that are related to HCV risk [10]. Hepatitis C is known to have a 10% chance of vertical transmission [11,12], compared with that of HIV, which varies between 15 and 45% in the absence of intervention in-utero, during labor or breastfeeding [13]. Existing standard treatment are known to have contraindications during pregnancy making it difficult for physicians to administer them [14,15].…”

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

“…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.…”