Data/hora: 11/06/2024 11:09:59

Provedor de dados: | 55
País: | Brazil
Título: | Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach
Autores: | Nogueira,Susie A.; Abreu,Thalita; Oliveira,Ricardo; Araújo,Lúcia; Costa,Tomaz; Andrade,Miriam; Psic,M. Fátima Garcia; Machado,Elizabeth; Rodrigues,Káris; Mercadante,Elizabeth Regina; Fernandes,Iraína; Sapia,M. Conceição; Lambert,John S.
Data: | 2001-04-01
Ano: | 2001
Palavras-chave: | Brazil; HIV; Prevention; Perinatal transmission; Zidovudine.
Resumo: | OBJECTIVES: To determine the HIV vertical transmission rate (VTR) and associated risk factors by use of zidovudine and infant care education in Brazil. METHODS: Since 1995, a prospective cohort of HIV infected pregnant women has been followed at the Federal University of Rio de Janeiro. A multidisciplinary team was established to implement the best available strategy to prevent maternal-infant HIV transmission. Patients with AIDS or low CD4 and high viral load received anti-retroviral drugs in addition to zidovudine. Children were considered infected if they had 2 positive PCR-RNA tests between 1 and 4 months of age, or were HIV antibody positive after 18 months. Education regarding infant treatment and use of formula instead of breast feeding was provided. RESULTS: Between 1995 and August, 2000, HIV status was determined for 145 infants. Compliance with intra-partum treatment, infant treatment and use of formula was 88.2%. Intra-partum zidovudine treatment was completed in 134/145 (92.6%) of patients; 88.1% had rupture of membranes &lt; 4 hours; 85.4% of mothers were asymptomatic. The mean CD4 count was 428.4 cells and mean viral load 39,050 copies. HIV vertical transmission rate was 4/145 (2.75%; CI: 0.1%-5.4%). The only risk factor significantly associated with transmission was a failure to use zidovudine intra-partum in 2 of the 4 mothers (50% versus 6.4% in non-transmitting mothers). A trend toward low CD4 and high viral load at entry, and rupture of membranes &gt; 4 hours were associated with increased HIV transmission. CONCLUSION: HIV vertical transmission in Brazil was reduced to a level similar to other countries with the most effective prevention programs using a multidisciplinary team approach. A high level of compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702001000200006
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1590/S1413-86702001000200006
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.5 n.2 2001
Fonte: | info:eu-repo/semantics/openAccess