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

Izabel Cristina Hoffmann,Wendel Mombaque Dos Santos,Sonia Maria Oliveira De Barros,Stela Maris De Mello Padoin

doi:10.1590/1516-3180.2016.0139140616

Izabel Cristina Hoffmann, Wendel Mombaque Dos Santos + Show 2 more

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https://doi.org/10.1590/1516-3180.2016.0139140616

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Abstract

Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it. Cross-sectional study developed at the University Hospital of Santa Maria (RS), Brazil. A cross-sectional study was conducted on a sample of 198 notification forms and medical records of HIV-positive pregnant women and exposed children. The vertical transmission rate was 2.4%, and three children had been infected by vertical HIV transmission. The statistically significant risk factor was the use of injectable drugs. Delayed reporting of pregnancy, absence of antiretroviral therapy during pregnancy, lack of proper prenatal care, incapacity to perform viral load detection tests and CD4+ T cell counts and obstetric and maternal clinical complications were reported. The vertical transmission rate was high and the recommended intervention measures were not adopted in full. Adequate prophylactic measures need to be implemented in HIV-positive pregnant women prenatally and during the antenatal, delivery and postpartum periods.

Highlights

Vertical transmission of human immunodeficiency virus (HIV) is characterized by passage of the virus from the mother to the child through the placenta during pregnancy, at the time of childbirth or through breastfeeding.[1,2,3,4] Children with HIV infection who develop acquired immunodeficiency syndrome (AIDS) stand out within the context of the epidemic
Its epidemiological growth is due to the feminization process and the increased survival rate among individuals infected through vertical transmission.[5,6]
In Brazil, the first cases of vertical transmission were reported in 1985.7 The Brazilian Ministry of Health uses the incidence rates among children under five years of age as an indicator for monitoring vertical transmission

Summary

Introduction

Vertical transmission of human immunodeficiency virus (HIV) is characterized by passage of the virus from the mother to the child through the placenta during pregnancy, at the time of childbirth or through breastfeeding.[1,2,3,4] Children with HIV infection who develop acquired immunodeficiency syndrome (AIDS) stand out within the context of the epidemic. Between 1980 and 2013, 12,551 cases of AIDS in children under 13 years of age who had been exposed to vertical transmission were reported in the notification information system.[1]. Through administering preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and prohibition of breastfeeding significantly reduces HIV transmission from mother to child.[9,10]

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