Mother-to-child transmission of human immunodeficiency virus type 1 infection
Keywords:Antiretroviral treatment, HIV infection, mother-to-child transmission, prevention
Introduction: Human Immunodeficiency Virus type 1 (HIV1) infection in children is almost related to mother-to-child transmission (MTCT). Without prophylaxis transmission rates are 15-25%. With appropriate prophylaxis <2% rates are achieved.
Objective: Evaluate the MTCT of HIV infection in a maternity.
Materials and Methods: Retrospective study, with review of clinical files of children whose mothers have HIV1 infection, born at Júlio Dinis Maternity from January 2006 to December 2011. Not infected was defi ned if 2 virologic tests were negative(one after 4 months of age) with no clinical signs of infection. Statistical analysis was performed with Epi-Info ® v.3.5.1 (Fisher test, p <0.05).
Results: Seventy seven children were born from HIV1 infected mothers, 45 (58.4%) males and 15 (19.5%) preterm infants. Diagnosis of maternal infection during pregnancy occurred in 24 (31.6%) and one at childbirth (1.3%). Seven (9.2%) hadn’t had antiretroviral therapy (ART) during pregnancy and 9 (12.3%) had viral load> 1,000 copies at childbirth. Normal delivery occurred in 4 (5.2%) and 10 (13%) had rupture of membranes (RM) # 4h. None was breastfed. All received prophylaxis in the neonatal period; 17 (22.1%) with 3 drugs, associated with absence of ART in pregnancy and at childbirth, maternal viral load> 1,000 copies,RM # 4h, spontaneous RM and prematurity. One newborn (1.3%) died. No child became infected. Almost a third (35.5%) had hematological toxicity and 23 (30.3%) had hepatic toxicity, both reversible.
Conclusion: In the population studied no MTCT of HIV1 infection occurred, despite the presence of factors that increase the risk of transmission in a high percentage of cases.
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