BACKGROUND: HIV infection in children is an important public health problem in the world, mainly in poorer countries. If all recommendations are followed, the elimination of HIV vertical transmission is a concrete possibility. This study aims to estimate vertical transmission rates of HIV in São Paulo State, Brazil, based on pregnant women diagnosed and reported in 2006, identifying potentially associated factors. METHODS: This study involves a retrospective cross-sectional analysis of information systems and records of infected pregnant women and children exposed to HIV. The rate of vertical transmission was estimated and variables associated with the antenatal, delivery, and postnatal periods were analyzed by the chi-square test, and Fisher exact test was used for variables with an expected frequency <5. The relative risks were calculated with 95% confidence intervals. RESULTS: The rate of vertical transmission in São Paulo state was 2.7% (95% confidence interval: 1.86 to 3.94) in 2006, decreasing 83.1% in comparison with 1988-1993. The main associated variables were lack of prenatal visits or <6 visits, no antiretroviral prophylaxis during labor or neonatal use for <6 weeks, and maternal breastfeeding. CONCLUSIONS: There is a decreasing trend of HIV vertical transmission in São Paulo with levels approaching elimination, which seems to be associated with antiretroviral policy and interruption of breastfeeding. Although there are serious operational issues, conditions exist to respond effectively. São Paulo state demonstrates that it is possible to achieve advanced levels of control for this mode of HIV transmission.
BACKGROUND:HIV infection in children is an important public health problem in the world, mainly in poorer countries. If all recommendations are followed, the elimination of HIV vertical transmission is a concrete possibility. This study aims to estimate vertical transmission rates of HIV in São Paulo State, Brazil, based on pregnant women diagnosed and reported in 2006, identifying potentially associated factors. METHODS: This study involves a retrospective cross-sectional analysis of information systems and records of infected pregnant women and children exposed to HIV. The rate of vertical transmission was estimated and variables associated with the antenatal, delivery, and postnatal periods were analyzed by the chi-square test, and Fisher exact test was used for variables with an expected frequency <5. The relative risks were calculated with 95% confidence intervals. RESULTS: The rate of vertical transmission in São Paulo state was 2.7% (95% confidence interval: 1.86 to 3.94) in 2006, decreasing 83.1% in comparison with 1988-1993. The main associated variables were lack of prenatal visits or <6 visits, no antiretroviral prophylaxis during labor or neonatal use for <6 weeks, and maternal breastfeeding. CONCLUSIONS: There is a decreasing trend of HIV vertical transmission in São Paulo with levels approaching elimination, which seems to be associated with antiretroviral policy and interruption of breastfeeding. Although there are serious operational issues, conditions exist to respond effectively. São Paulo state demonstrates that it is possible to achieve advanced levels of control for this mode of HIV transmission.
Authors: Rodrigo Cerda; Freddy Perez; Rosa Maria S M Domingues; Paula M Luz; Beatriz Grinsztejn; Valdilea G Veloso; Sonja Caffe; Jordan A Francke; Kenneth A Freedberg; Andrea L Ciaranello Journal: Open Forum Infect Dis Date: 2015-05-22 Impact factor: 3.835
Authors: Pedro Alves da Cruz Gouveia; Gerlane Alves Pontes da Silva; Maria de Fatima Pessoa Militão de Albuquerque Journal: BMC Public Health Date: 2014-11-27 Impact factor: 3.295
Authors: Suwellen Sardinha Dias de Azevedo; Edson Delatorre; Cibele Marina Gaido; Carlos Silva-de-Jesus; Monick Lindenmeyer Guimarães; José Carlos Couto-Fernandez; Mariza G Morgado Journal: Viruses Date: 2022-08-12 Impact factor: 5.818
Authors: Vanessa Terezinha Gubert de Matos; Fabiani de Morais Batista; Naiara Valera Versage; Clarice Souza Pinto; Vanessa Marcon de Oliveira; Érica Freire de Vasconcelos-Pereira; Roberta Barbeta Dos Rios de Matos; Márcia Maria Ferrairo Janini Dal Fabbro; Ana Lúcia Lyrio de Oliveira Journal: Braz J Infect Dis Date: 2018-05-09 Impact factor: 3.257