Abstract
Abstract Background HIV infection affects women of childbearing age, and unplanned pregnancies among those infected are prevalent. This fact increases the potential risk for mother-to-child transmission during pregnancy, childbirth or postpartum through breastfeeding. The Brazilian Ministry of Health recommends anti-HIV testing for all pregnant women. Access to antiretroviral therapy is available through prenatal and maternity care, and breastfeeding is contraindicated. The detection rate of pregnant women living with HIV in Brazil has increased by 23.8% in the last ten years. The aim of this study was to estimate the incidence of seroconversion of HIV infection in children exposed to mother-to-child transmission and examine associated risk factors for the period 2007-2017 in Santa Catarina, Brazil. Methods A historical cohort study was conducted using secondary data related to the notifications of HIV-infected pregnant woman and follow-up of HIV-exposed infants. Odds ratios were used to estimate the risk of infection. Results We identified 5,554 HIV-infected pregnant women and 4,559 HIV-exposed infants, 130 of whom had confirmed seroconversion, which corresponds to a rate of 2.9%. Antiretroviral use during pregnancy [OR = 9.31 (5.97-14.52) p < 0.001] and breastfeeding [OR = 3.10 (1.34-7.20) p = 0.008] were found to be independent risk factors for seroconversion. Between 2007 and 2017, there was a 78.3% increase in the number of HIV-infected pregnant women, but the seroconversion rate among infants reduced by 20.4%. Conclusions The study concluded that, between 2007 and 2017, the HIV seroconversion rate was 2.9% among live births, with a tendency to decrease. Seroconversion was associated with not using antiretroviral therapy during pregnancy and breastfeeding. These data reveal gaps in prenatal care regarding adherence to treatment and follow-up of HIV-infected mothers, resulting in new HIV infections among children that could otherwise be prevented. Key messages Vertical transmission of HIV is a public health challenge, which requires strategies for surveillance and quality care. This study may provide relevant information to promote public health policies, with quality care for pregnant women and children living with HIV/AIDS.
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