New diagnosis of mother-to-child transmission of HIV in 8 Latin-American countries during 2018.

Autor: Hernanz-Lobo A; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. h.lobo.alicia@gmail.com.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain. h.lobo.alicia@gmail.com.; Department of Paediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain. h.lobo.alicia@gmail.com., Ruiz Saez B; Department of Paediatrics, Hospital Reina Sofía, Córdoba, Spain., Carrasco García I; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain., Mino-Leon G; Department of Paediatrics, Hospital del Niño Dr. Francisco de Icaza Bustamante, Guayaquil, Ecuador.; CYTED (Ibero-American Programme of Science and Technology for Development)., Juárez J; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital Roosevelt, Guatemala City, Guatemala., Pavía Ruz N; CYTED (Ibero-American Programme of Science and Technology for Development).; Paediatric HIV/AIDS Clinic, Facultad de Medicina, UNAM/HGM, Universidad Nacional Autónoma de México, Mexico City, México., Estripeaut D; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital del Niño Dr. José Renán Esquivel, Panama City, Panama.; Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panama City, Panama., Pérez MLÁ; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital Infantil de Nicaragua, Managua, Nicaragua., Erazo K; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital Dr. Mario Catarino Rivas, San Pedro Sula, Honduras., Castaneda Villatoro LG; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador., Porras O; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, San José, Costa Rica., Prieto Tato LM; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital Doce de Octubre, Madrid, Spain., Navarro Gómez ML; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.; CYTED (Ibero-American Programme of Science and Technology for Development).; Department of Paediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Department of Paediatrics, Complutense University of Madrid, Madrid, Spain.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2022 Apr 07; Vol. 22 (1), pp. 347. Date of Electronic Publication: 2022 Apr 07.
DOI: 10.1186/s12879-022-07311-8
Abstrakt: Background: Important prevention efforts have led to a reduction in mother-to-child transmission of HIV (MTCT) globally. However, new cases of paediatric HIV infections still occur. Early diagnosis of new HIV infections is essential to start an appropriate antiretroviral treatment to avoid childhood morbidity and mortality related to infection. The aim of this study was to describe the new cases of MTCT in Latin-American referral hospitals.
Methods: A retrospective, multicentre and descriptive study of the new cases of MTCT diagnosed during 2018 in 13 referral hospitals from 8 Latin-American countries (Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama) belonging to PLANTAIDS (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children), was conducted. PLANTAIDS is included in CYTED (Ibero-American Programme of Science and Technology for Development).
Results: Eighty-one children (40.7% males) were included, median age at diagnosis of 2.33 years (IQR:0.7-4.7). Less than 3% of women knew their HIV diagnosis before pregnancy. More than 80% of them were diagnosed after delivery, 8.7% during pregnancy, and 2.9% at delivery. Only one patient underwent antiretroviral therapy (ART) prior to pregnancy. At diagnosis, 50.0% of the children presented with an advanced stage of disease (stage C following the current CDC classification for HIV infection), and 34.4% had less than 15% CD4 + cells/mm 3 . The time elapsed between delivery and the maternal diagnosis was correlated with the age of children at diagnosis, ρ = 0.760, p < 0.001. Younger age at diagnosis (p = 0.03), a smaller number of previous hospitalizations (p < 0.01), and better immunovirological status (p < 0.01) were found in children whose mothers knew their HIV status at delivery, compared to mothers who were not aware of it.
Conclusions: Although MTCT in Latin America has declined in recent years, our series shows there are still cases that indicate some failures in prevention, being a critical point to improve an earlier diagnosis of pregnant women. Half of the children were diagnosed in an advanced stage of disease and the delay in maternal diagnosis entailed a worse clinical and immunological child' prognosis.
(© 2022. The Author(s).)
Databáze: MEDLINE
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