310 Towards Elimination of Vertical Transmission of Hiv in SãO Paulo State, Brazil - Analysis of the Period 1984-2008

• Published in: Pediatric research Vol. 68; no. Suppl 1; p. 159
• Main Authors: Matida, L H, Junior, Ramos A N, Silva, M H, Domingues, C S B, Tayra, A, Gianna, M C, Hearst, N
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-11-2010
• Subjects: Medicine & Public Health; Pediatric Surgery; Pediatrics; poster-presentation
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1203/00006450-201011001-00310

Background: São Paulo State has been a pioneer in adopting measures for prevention of mother-tochild transmission (MTCT) of HIV since the mid- 1990s. Consequently, HIV infection in children has steadily diminished. Reported AIDS cases in children under five is a useful proxy for MTCT.
Methods: We studied AIDS incidence rates in children under five in São Paulo (Brazil southeast) in period 1984-2008. Cases were tabulated using government reporting system (SINAN), with denominators from Brazilian Institute of Geography and Statistics based on census and inter-census estimates.
Results: During 1984-1996, there was an increase in incidence rates from 0.03 to 12.77 per 100,000 population, an increase of 425-fold. After implementation of HAART universal access (1996 to present), there was a significant reduction in incidence. The incidence rate fell 90.6%, from 12.77 to 1.20 cases per 100,000. This drop took place mainly after 2000, when routine diagnostic and preventive strategies were implemented for pregnant women and exposed children. The figure plots incidence by year, indicating when various preventive measures were adopted.
Figure
Figure
[Vertical Transmission of AIDS, Sao Paulo, Brazil]
Conclusions: AIDS incidence in children is falling in São Paulo State due to adoption of effective control strategies. International goals (i.e., two cases per 100 infected women) for “eliminating” MTCT will certainly be met. Nevertheless, maintaining preventive activities and comprehensive care will remain a challenge in settings with broad social inequality. The 70 cases of AIDS in children under five diagnosed in São Paulo State in 2008 serve as a reminder of this.