Transmisión madre-hijo del VIH según quimioprofilaxis recibida, vía de nacimiento y amamantamiento

Jorge Quian; Stella Gutiérrez; Teresa Picón; Ana Visconti; Alicia González; Margarita Nin; Jaqueline Martín; Ana Galli; Virginia Galeano

Authors

Jorge Quian Universidad de la República, Facultad de Medicina, Pediatría, Profesor Agregado
Stella Gutiérrez Universidad de la República, Facultad de Medicina, Pediatría, Profesora Adjunta. Farmacología, Profesora Adjunta
Teresa Picón Médica Pediatra
Ana Visconti Universidad de la República, Facultad de Medicina, Clínica Ginecoobstétrica, Asistente
Alicia González Médica Pediatra
Margarita Nin Médica Pediatra
Jaqueline Martín Médica Pediatra
Ana Galli Universidad de la República, Facultad de Medicina, Pediatría, Residente
Virginia Galeano Asistente Social

Keywords:

VERTICAL TRANSMISSION OF DISEASE, HIV INFECTIONS, CHEMOPREVENTION, ANTI-HIV AGENTS

Abstract

HIV positive mothers and their children born between 1st January 1995 and 30th June 2000 were studied.
Objective. To analyze HIV mother-to-child transmission related to prophylactic therapy, delivery mode and breastfeeding.
Methods. Children were categorized as infected, serum-reverted or exposed.
Three groups were established: A) without prophylactic therapy, B) zidovudine (ZDV) during pregnancy, labor or cesarean and newborn of at least 42 days old, C) more than one antiretroviral drug during pregnancy and ZDV in labor or cesarean, and newborn of at least 42 days old.
Infants were considered as breastfed if they had been receiving mother-milk during more than one week. Delivery modes such as labor, elective cesarean or emergency cesarean were analyzed.
Birth weight, gestational age and quantity of pregnancies.
Results. In the group A eighty-two mother-child pairs were enrolled in the study, of which they were 41 infected infants (50%). Breastfed infants accounted for 42% (34 infants). In relation to delivery mode, vaginal was seen in 58 mothers (70%) and elective cesarean for 7. The group B was composed by 101 mother-child pairs with 5 infected infants (5%). Two infants were breastfed. Vaginal delivery was seen in 62 patients (61%) and there were 29 cesarean of choice (29%), and the group C by 34 pairs of whom 34 infants were serum-reverted, 33 were not breastfed, no data in the other case. Elective cesarean accounted for 26,5%.
There were no differences between the three groups on weight, pregnancy age, mother's age or quantity of pregnancies.
Conclusions. HIV mother-to-child transmission frankly decrease with antiretroviral treatment. Increase in elective cesarean and no breastfeeding are associated with this condition.

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