INTRODUCTION: While the rate of vertically transmitted HIV infection has fallen in most regions of Brazil, there have been no similar decreases in northern and northeastern Brazil. OBJECTIVE: The objective of this study was to evaluate the risk factors associated with vertical transmission in the state of Sergipe in northeastern Brazil. METHODS: This was a retrospective cohort study. We recorded clinic and registry data for all HIV-infected pregnant women and exposed children diagnosed in Sergipe from 1990 to 2011. RESULTS: We identified 538 deliveries and 561 HIV-exposed infants (23 sets of twins). One hundred one (18.9%) infants were HIV-infected. In the multivariate analysis, infant antiretroviral prophylaxis was a significant protective factor (adjusted odds ratio (aOR) 0.07, 95% confidence interval (CI) 0.01-0.41, p=0.003). Breastfeeding was marginally associated with an increased odds of perinatal transmission (aOR 4.52, 95% CI 0.78-26.17, p = 0.092). The attributable risk percentage for breastfeeding over the study period was 91.0%. Transmission decreased from 91 per 100 live births before 1997 to 2 per 100 in 2011 following the adoption of the prevention protocol. CONCLUSION: Transmission declined over the study period. The screening of pregnant women and timely initiation of prophylaxis and therapy are issues that require further attention.
INTRODUCTION: While the rate of vertically transmitted HIV infection has fallen in most regions of Brazil, there have been no similar decreases in northern and northeastern Brazil. OBJECTIVE: The objective of this study was to evaluate the risk factors associated with vertical transmission in the state of Sergipe in northeastern Brazil. METHODS: This was a retrospective cohort study. We recorded clinic and registry data for all HIV-infected pregnant women and exposed children diagnosed in Sergipe from 1990 to 2011. RESULTS: We identified 538 deliveries and 561 HIV-exposed infants (23 sets of twins). One hundred one (18.9%) infants were HIV-infected. In the multivariate analysis, infant antiretroviral prophylaxis was a significant protective factor (adjusted odds ratio (aOR) 0.07, 95% confidence interval (CI) 0.01-0.41, p=0.003). Breastfeeding was marginally associated with an increased odds of perinatal transmission (aOR 4.52, 95% CI 0.78-26.17, p = 0.092). The attributable risk percentage for breastfeeding over the study period was 91.0%. Transmission decreased from 91 per 100 live births before 1997 to 2 per 100 in 2011 following the adoption of the prevention protocol. CONCLUSION: Transmission declined over the study period. The screening of pregnant women and timely initiation of prophylaxis and therapy are issues that require further attention.
Authors: Célia Landmann Szwarcwald; Aristides Barbosa Júnior; Paulo Roberto Borges de Souza-Júnior; Kátia Regina Valente de Lemos; Paulo Germano de Frias; Karin Regina Luhm; Marcia Moreira Holcman; Maria Angela Pires Esteves Journal: Braz J Infect Dis Date: 2008-06 Impact factor: 1.949
Authors: E C Joao; M I Gouvêa; J A Menezes; L C Sidi; M L S Cruz; P T Berardo; L Ceci; C A Cardoso; M de L B Teixeira; G A Calvet; H J Matos Journal: Int J STD AIDS Date: 2012-01 Impact factor: 1.359
Authors: P M Garcia; L A Kalish; J Pitt; H Minkoff; T C Quinn; S K Burchett; J Kornegay; B Jackson; J Moye; C Hanson; C Zorrilla; J F Lew Journal: N Engl J Med Date: 1999-08-05 Impact factor: 91.245
Authors: Amy Stewart Nunn; Elize Massard da Fonseca; Francisco I Bastos; Sofia Gruskin Journal: Health Aff (Millwood) Date: 2009 Jul-Aug Impact factor: 6.301
Authors: Jennifer Y Chen; Heather J Ribaudo; Sajini Souda; Natasha Parekh; Anthony Ogwu; Shahin Lockman; Kathleen Powis; Scott Dryden-Peterson; Tracy Creek; William Jimbo; Tebogo Madidimalo; Joseph Makhema; Max Essex; Roger L Shapiro Journal: J Infect Dis Date: 2012-10-12 Impact factor: 5.226
Authors: Anna Coutsoudis; Francois Dabis; Wafaie Fawzi; Philippe Gaillard; Geert Haverkamp; D Robert Harris; J Brooks Jackson; Valerie Leroy; Nicolas Meda; Philippe Msellati; Marie-Louise Newell; Ruth Nsuati; Jennifer S Read; Stefan Wiktor Journal: J Infect Dis Date: 2004-05-26 Impact factor: 5.226
Authors: M Tornatore; C V Gonçalves; R A Mendoza-Sassi; J M Silveira; N E D'ávila; C G Maas; M S Bianchi; E M Pinheiro; E S Machado; M A Soares; A M B Martinez Journal: Int J STD AIDS Date: 2010-05 Impact factor: 1.359
Authors: David R Martinez; Nathan Vandergrift; Ayooluwa O Douglas; Erin McGuire; John Bainbridge; Nathan I Nicely; David C Montefiori; Georgia D Tomaras; Genevieve G Fouda; Sallie R Permar Journal: J Virol Date: 2017-04-13 Impact factor: 5.103
Authors: Tessa Concepcion; Jennifer Velloza; Christopher G Kemp; Amritha Bhat; Ian M Bennett; Deepa Rao; Christina S Polyak; Julie A Ake; Allahna Esber; Nicole Dear; Jonah Maswai; John Owuoth; Valentine Sing'oei; Emmanuel Bahemana; Michael Iroezindu; Hannah Kibuuka; Pamela Y Collins Journal: AIDS Behav Date: 2022-10-09