Abstract

The increase in the number of AIDS cases among women has led to an increase in the maternal-infant transmission of human acquired immunodeficiency virus. Measures for the control of this type of transmission were implemented in Brazil in 1996. The aim of the present study was to analyze time trends in maternal-infant transmission of AIDS among Brazilian children. The present study included children born in Brazil between 1990 and 2001. We used the database of notified AIDS cases in children 13 years of age or younger between 1990 and 2004. Exponential regression models adjusted to the time series provided the annual variation rates and observed and expected values for the period. We found a significant increasing trend for cases born prior to the year in which anti retroviral therapy was introduced, with an increase rate of about 12% (t<0.003) per year. Rates from different states ranged from 5.9% to 31%. The analysis of expected and observed cases for each of the country's five Regions showed a reduction in the number of cases among children born from 1997 onwards, with a progressive year-to-year reduction. The number of notified cases among children born in 2001 was less than 10% the number of expected cases. The results obtained suggest a favorable response to the implementation of policies for the prevention of maternal-infant HIV transmission in Brazil, as observed in other parts of the world.

Highlights

  • The patterns of dissemination of infection by the human acquired immunodeficiency virus (HIV) have changed due to the predominance of heterosexual transmission

  • The increase in the number of cases among women led to an increase in maternal-infant transmission of HIV infection, with consequent increase in the number of cases of AIDS in children worldwide

  • The probability of maternal-infant transmission of HIV infection has been calculated in a number of studies.[4,5,6,10,11]

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Summary

Introduction

The patterns of dissemination of infection by the human acquired immunodeficiency virus (HIV) have changed due to the predominance of heterosexual transmission. This has been decisive for the increase in the incidence of the disease among women. The increase in the number of cases among women led to an increase in maternal-infant transmission of HIV infection, with consequent increase in the number of cases of AIDS in children worldwide. Studies[5,6,10] show that a number of factors are associated with increased risk of maternal-infant transmission of HIV. Major risk factors include the time between the rupture of amniotic membranes and delivery and the amount of virus in the mother’s cervical-vaginal secretions and breast milk

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