[HIV-mother-to-child transmission in a tertiary hospital in the era of generalization of preventive interventions]

Autor: M Angeles, López-Vílchez, Mónica, Guxens Junyent, Estanislao, Mur Milà, Antonio, Mur Sierra
Rok vydání: 2008
Předmět:
Zdroj: Medicina clinica. 132(13)
ISSN: 0025-7753
Popis: Since 1994, when the PACTG 076 results were published, the rate of vertical transmission has decreased from 25% to 2%. Nowadays the prevalence of HIV infection in Catalan pregnant women is 0.17% yet it is 0.5% in our hospital. Our objectives were: to analyze the number of new cases of HIV infection by vertical transmission; to determine the importance of risk factors; to prove how important is to identify HIV-infected pregnant women; to determine the role of the rapid HIV-1 testing in labour room; and to detect mistakes in the prophylactic strategies.One hundted and twenty four newborns from HIV-infected pregnant women born in Hospital del Mar were prospectively followed from 1996-2005. All them were separated in different groups in order to compare them.Eight children were infected, corresponding to 6.45%. In the group of newborns whose mothers were identified as infected during pregnancy, even with prophylactic measures well done, the transmission rate was 3.6% and it was 3.8% in the group born after 1999. When the prophylactic strategies were correct, 30% of pregnant women reached delivery with HIV RNA1,000/ml copies. In the multivariate analysis, two variables were significant: amniorrhexis4h and lack of identification of pregnant women as being HIV positive.The identification of HIV-pregnant women has been crucial to avoid HIV mother-to-child transmission. Rapid HIV-1 testing in labour room is key to set up preventive strategies in order to avoid the infection in the newborn. Adequate prophylaxis percentages are still low and improvement is needed.
Databáze: OpenAIRE
Popis
Abstrakt:Since 1994, when the PACTG 076 results were published, the rate of vertical transmission has decreased from 25% to 2%. Nowadays the prevalence of HIV infection in Catalan pregnant women is 0.17% yet it is 0.5% in our hospital. Our objectives were: to analyze the number of new cases of HIV infection by vertical transmission; to determine the importance of risk factors; to prove how important is to identify HIV-infected pregnant women; to determine the role of the rapid HIV-1 testing in labour room; and to detect mistakes in the prophylactic strategies.One hundted and twenty four newborns from HIV-infected pregnant women born in Hospital del Mar were prospectively followed from 1996-2005. All them were separated in different groups in order to compare them.Eight children were infected, corresponding to 6.45%. In the group of newborns whose mothers were identified as infected during pregnancy, even with prophylactic measures well done, the transmission rate was 3.6% and it was 3.8% in the group born after 1999. When the prophylactic strategies were correct, 30% of pregnant women reached delivery with HIV RNA1,000/ml copies. In the multivariate analysis, two variables were significant: amniorrhexis4h and lack of identification of pregnant women as being HIV positive.The identification of HIV-pregnant women has been crucial to avoid HIV mother-to-child transmission. Rapid HIV-1 testing in labour room is key to set up preventive strategies in order to avoid the infection in the newborn. Adequate prophylaxis percentages are still low and improvement is needed.
ISSN:00257753