Abstract
The diagnosis of human immunodeficiency virus (HIV) in parturient women is used to prevent or change the course of HIV perinatal transmission through the zidovudine prophylaxis regimen. The aims of this study were to determine the prevalence of the HIV infection using the rapid test, to evaluate its acceptance for the diagnosis of HIV infection, and to determine the risk factors for HIV infection in parturients. Interview and a rapid test for anti-HIV were carried out on 4,341 parturients attended at two main public maternities (Maternity of the University Hospital and Municipal Maternity “Lucilla Ballalai”), in the city of Londrina, Paraná, Brazil, from May, 2000, to September, 2001. The rapid test was positive in 23 (0.52%) parturients evaluated. Of them, the seropositivity in the conventional (screening and confirmatory) tests was obtained in 19 (0.44%; 95% CI: 0.27 – 0.70). The rate of the rapid test acceptance was 99.7%. Among HIV-infected. parturient it was found higher frequency (52.6%) of intravenous drug-user sexual partner (Odds ratio 51.63, 95% CI: 18.67-143.51, p< 0.0001) when compared with HIV-uninfected parturients, and also with a diagnosed seropositive partner (42.1%) when compared with HIV-uninfected parturients (Odds ratio 1011.88, 95% CI: 201.87-5766.26, p<0.0001). However, 15.8% of the HIV-infected parturient denied the existence of any risk factor for HIV infection. The results of this study emphasize the useful of the rapid test to diagnose the HIV infection in all parturient.
Highlights
Since the description of the first case of AIDS, in1980, it has been observed a worldwide progressive increase of the number of people infected with the human immunodeficiency virus (HIV)
The results showed a specificity of the rapid test for anti-HIV of 99.6% (C.I.:95% 99.0-99.9%), predictive positive value of 82.6% (C.I.:95% 60.5-94.3%), and predictive negative value of 100.0% (C.I.:95% 99.6100.0%)
One parturient was not attended during the prenatal; other woman had only one sexual partner and was not evaluated during the prenatal because her husband showed a negative result for antiHIV antibodies during a previous blood donation before the pregnancy, and the rapid test was considered unnecessary by her obstetric; in the third parturient, the diagnosis of HIV infection was not made during the prenatal period because she was received the serologic result, assayed during the first trimester of the pregnancy, with incorrect result
Summary
Since the description of the first case of AIDS, in1980, it has been observed a worldwide progressive increase of the number of people infected with the human immunodeficiency virus (HIV). Use of rapid test for the diagnosis of human immunodeficiency virus (HIV) infection in parturient. HIV-1 can be transmitted from an infected woman to her fetus or newborn during pregnancy, during labor and delivery, and during the postpartum period through breastfeeding. Diagnosis of HIV-1 infection before, during pregnancy, or in the labor period, allows the use of strategies to prevent perinatal HIV transmission. Previous studies demonstrated that the administration of zidovudine (ZDV) to the HIVinfected women during pregnancy, labor, and delivery and to their newborn reduced the risk for perinatal HIV transmission by approximately two thirds: 25.5% of infants born from mothers that did not receive ZDV regimen were infected, compared with 8.3% of those born from mothers that received ZVD prophylaxis regimen.[3,4,5]
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