Vertical transmission of HIV from 2007 to 2018 in a reference university hospital in Rio de Janeiro

The aim of the study was to assess the factors associated with mother-to-child transmission (MTCT) of HIV. The study design is a retrospective cohort. The population consisted of 323 HIV-positive mothers and their newborns, attended at the Perinatal Nucleus/HUPE-UERJ, municipality of Rio de Janeiro,...

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Published in:	Revista do Instituto de Medicina Tropical de São Paulo Vol. 62; pp. 1 - 10
Main Authors:	Gouvêa, Abilene do Nascimento, Trajano, Alexandre José B., Monteiro, Denise L. M., Rodrigues, Nádia Cristina P., Costa, Julie Teixeira da, Cavalcante, Mateus Benac, Auar, Daniela Fortunato, Gouvea, Erika Ferraz de, Taquette, Stella Regina
Format:	Journal Article
Language:	English
Published:	São Paulo Instituto de Medicina Tropical de Sao Paulo 01-01-2020 Instituto de Medicina Tropical Instituto de Medicina Tropical de São Paulo Universidade de São Paulo (USP)
Subjects:	HIV Incidence Original Pregnancy TROPICAL MEDICINE Vertical infectious disease transmission Vertical infectious disease transmission Pregnancy HIV Incidence
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Summary:	The aim of the study was to assess the factors associated with mother-to-child transmission (MTCT) of HIV. The study design is a retrospective cohort. The population consisted of 323 HIV-positive mothers and their newborns, attended at the Perinatal Nucleus/HUPE-UERJ, municipality of Rio de Janeiro, in the period of 2007-2018. The average age of mothers was 27 years (14-44), with 12.7% (41) of adolescents. The majority (66.8%) knew they were infected during pregnancy: 39.4% in the current pregnancy and 27.4% in a previous pregnancy. The incidence of MTCT was 2.7% in 2007-2009, 1% in 2010-2015 and 0 in 2016-2018. The viral load in the 3 rd trimester of pregnancy was > 1.000 copies/mL or unknown in all mothers with positive newborns and in 19% (42/221) of mothers with negative newborns (p=0.003). The duration of antiretroviral use was > 4 weeks in 92.3% (264/286) of mothers with HIV-negative newborns and in 2 in the HIV-positive group (p=0.004). One of the 4 infected newborns and 2 of the negative ones did not use oral zidovudine (p=0.04). There was no association between amniorrhexis and MTCT (p=0.99), with the Apgar score in the 5 th minute of life (p=0.96), with marital status (p=0.54), ethnicity (p=0.65), adolescence (p=0.42), mode of delivery (p=0.99), beginning of prenatal care (p=0.44) or with maternal comorbidities (p=0.48). The conclusion of the study points out that the main factors associated with MTCT are the elevated maternal viral load in the 3 rd trimester, the time of use of ART and the non-administration of zidovudine for the newborns.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The authors have declared that no conflict of interests exist. CONFLICT OF INTERESTS AUTHORS’ CONTRIBUTIONS ANG, AJBT, DLMM and NCPR developed the study design and method; ANG, DLMM, NCPR, JTC, MBC and DFA evaluated the data and participated in the results elaboration; DLMM, NCPR, JTC and MBC analyzed the data; ANG, AJBT, DLMM, JTC, MAB and DFA wrote the manuscript; DLMM, AJBT, EFG and SRT edited and revised the manuscript. All authors read and approved the final edition of the manuscript.
ISSN:	1678-9946 0036-4665 1678-9946
DOI:	10.1590/S1678-9946202062066