A five-year review of vertical HIV transmission in a specialized service
cross-sectional study
Keywords:
HIV, Infectious disease transmission, vertical, Women’s health, Child health, Hospital recordsAbstract
CONTEXT AND OBJECTIVE: 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. DESIGN AND SETTING: Cross-sectional study developed at the University Hospital of Santa Maria (RS), Brazil. METHODS: A cross-sectional study was conducted on a sample of 198 notification forms and medical records of HIV-positive pregnant women and exposed children. RESULTS: 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. CONCLUSIONS: 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.
Downloads
References
Brasil. Ministério da Saúde. Boletim Epidemiológico. HIV-AIDS. Brasília: Ministério da Saúde; 2013. Available from: http://www.aids.gov.br/sites/default/files/anexos/publicacao/2013/55559/_p_boletim_2013_internet_pdf_p51315.pdf. Accessed in 2016 (Jul 6).
Santos RCS, Souza MJA. HIV na gestação. Estação Científica (UNIFAP). 2012;2(2):11-24. Available from: https://periodicos.unifap.br/index.php/estacao/article/view/535/santosv2n2.pdf. Accessed in 2016 (Jul 6).
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de DST e Aids. Protocolo para a prevenção de transmissão vertical de HIV e sífilis: manual de bolso. Brasília: Ministério da Saúde; 2007. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_prevencao_transmissao_verticalhivsifilis_manualbolso. pdf. Accessed in 2016 (Jul 6).
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de DST e Aids. Recomendações para Profilaxia da Transmissão Vertical do HIV e Terapia Antirretroviral em Gestantes: manual de bolso. Brasília: Ministério da Saúde; 2010. Available from: http://www.aids.gov.br/sites/default/files/consenso_gestantes_2010_vf.pdf. Accessed in 2016 (Jul 6).
Nichols J, Steinmetz A, Paintsil E. Impact of HIV-Status Disclosure on Adherence to Antiretroviral Therapy Among HIV-Infected Children in Resource-Limited Settings: A Systematic Review. AIDS Behav. 2016 Jul
[Epub ahead of print].
Fang L, Chuang DM, Lee Y. Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample. Prev Med Rep. 2016;4:113-20.
Zunza M, Mercer GD, Thabane L, et al. Effects of postnatal interventions for the reduction of vertical HIV transmission on infant growth and non-HIV infections: a systematic review. J Int AIDS Soc. 2013;16:18865.
Lemos LMD, Rocha TFS, Conceição MV, et al. Avaliação das ações de prevenção da transmissão materno-infantil do HIV em Aracaju, Estado de Sergipe, Brasil [Evaluation of preventive measures for mother-to- child transmission of HIV in Aracaju, State of Sergipe, Brazil]. Rev Soc Bras Med Trop. 2012;45(6):682-6.
Park JW, Yang TW, Kim YK, et al. Ten years of experience in the prevention of mother-to-child human immunodeficiency virus transmission in a university teaching hospital. Korean J Pediatr. 2014;57(3):117-24.
Boldori HM, Santos WM, Hoffmann IC, et al. Factors associated with miscarriage and perinatal mortality in women with HIV infection. International Research Journal of Medicine and Medical Sciences. 2014;2(4):73-8. Available from: http://www.netjournals.org/pdf/IRJMMS/2014/4/14-033.pdf. Accessed in 2016 (Jul 6).
Rodrigues STC, Vaz MJR, Barros SMO. Transmissão vertical do HIV em população atendida no serviço de referência [Vertical transmission of HIV in the population treated at a reference center]. Acta Paul Enferm. 2013;26(2):158-64.
Moura EL, Kimura AF, Praça NS. Ser gestante soropositivo para o Vírus da Imunodeficiência Humana: uma leitura à luz do Interacionismo Simbólico [Being pregnant seropositive and having acquired the human immunodeficiency Virus (HIV): a theoretical interpretation under the Symbolic Interactionism]. Acta Paul Enferm. 2010;23(2):206-11.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de DST e Aids. Recomendações para Terapia Antirretroviral em Crianças e Adolescentes Infectados pelo HIV: manual de bolso. Brasília: Ministério da Saúde; 2009. Available from: http://www.aids.gov.br/sites/default/files/consenso_pediatrico.pdf. Accessed in 2016 (Jul 6).
Hoffmann IC, Santos WM, Silva CB, et al. Fatores que interferem na transmissão vertical do HIV: revisão integrativa [Risk factors that interfere on vertical transmission of HIV: integrative review]. Enfermagem Obstétrica. 2014;1(1):31-9. Available from: http://www.enfo.com.br/ojs/index.php/EnfObst/article/view/8/10. Accessed in 2016 (Jul 6).
Liotta G, Marazzi MC, Mothibi KE, et al. Elimination of Mother-To- Child Transmission of HIV Infection: The Drug Resource Enhancement against AIDS and Malnutrition Model. Int J Environ Res Public Health. 2015;12(10):13224-39.
Whitmore SK, Taylor AW, Espinoza L, et al. Correlates of mother-to-child transmission of HIV in the United States and Puerto Rico. Pediatrics. 2012;129(1):e74-81.
Bhardwaj S, Barron P, Pillay Y, et al. Elimination of mother-to-child transmission of HIV in South Africa: rapid scale-up using quality improvement. S Afr Med J. 2014;104(3 Suppl 1):239-43.
Zeng H, Chow EP, Zhao Y, et al. Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis. Sex Transm Infect. 2016;92(2):116-23.
Carlsson-Lalloo E, Rusner M, Mellgren A, Berg M. Sexuality and Reproduction in HIV-Positive Women: A Meta-Synthesis. AIDS Patient Care STDS. 2016;30(2):56-69.
