Vertical transmission of the HIV in women who are users of the Pereira Rossell Hospital Center, Uruguay 2012-2014. Results of the application of the Zidovudine - Nevirapine combined protocol in Uruguayan children

Abstract

Introduction:

controlled pregnancy and interruption of breastfeeding are strategies used to reduce vertical transmission of the immunodeficiency virus (HIV). Neonates are subject to prophylactic treatment of zidovudine or combination therapy with zidovudine and nevirapine based on the mother-to-child transmission risk.

Objective:

to describe mother-to-child transmission from 2012 to 2014 at the Pereira Rossell Hospital Center, its relationship with the maternal viral load and the observation of the AZT-NVP prophylactic treatment recommended for neonates.

Method:

descriptive study, at the Obstetric Pediatrix HIV-Aids Reference Center from September 1, 2012 until December, 31, 2014. The newborns to mother with detectable or undetectable viral loads at the time of delivery. Administration of zidovudine-nevirapine was recorded. Vertical transmission was defined.

Results:

162 women were included in the study, 86 of them with a detectable or unknown viral load and 76 women with a detectable load. The first group gave birth to 88 children and the second one to 76. Global mother-to-child transmission rate was 4.9%, 9% in the first group and 0% in the second one. The association between mother-to-child transmission and maternal load was recorded (P<0.05). Administration of AZT-NVP was indicated in 45.5% of children. Intrauterine mother-to child transmission was 5 for the 8 infected children. As to the other three children: 2 received AZT and another one received no prophylactic therapy.

Discussion and conclusions:

fifty per cent of the women’s pregnancies were not dully controlled. Average mother-to-child transmission was 4.9%. Out of the 8 infected cases, 5 happened in the uterus, only an early diagnosis and treatment would have prevented it from happening. The AZT-NVP protocol is not applied in the right way. Its application on the other 3 children may have avoided the infection.