Vertical transmission of human immunodeficiency virus

Follow-up of children born to VIH infected women in a healthcare institution. Uruguay (2008-2011)

  • Mariana Más Universidad de la República, Facultad de Medicina, Departamento de Emergencia Pediátrica. Prof. Adj. de Emergencia Pediátrica. Médica Uruguaya, Policlínica de Infectología. Pediatra
  • Patricia Barrios Universidad de la República, Facultad de Medicina, Departamento de Pediatría y Especialidades. Prof. Adj. de Pediatría. Médica Uruguaya, Policlínica de Infectología. Pediatra
  • Gustavo Giachetto Universidad de la República, Facultad de Medicina, Departamento de Pediatría y Especialidades. Clínica Pediátrica. Profesor Titular. Médica Uruguaya, Consultante de Infectología Pediátrica
  • Beatriz Sayagués Médica Uruguaya, Centro Intensivo Neonatal y Pediátrico. Jefa. Pediatra
  • Carolina Morales Médica Uruguaya, Unidad de Notificación y Apoyo a pacientes con VIH-SIDA. Coordinadora. Licenciada en Trabajo Social
  • Olga Hernández Universidad de la República, Facultad de Medicina, Cátedra de Infectología. Ex Prof. Agdo. Médica Uruguaya, Infectólogo consultante
Keywords: INFECTIOUS DISEASE TRANSMISSION, VERTICAL HIV INFECTIONS

Abstract

Introduction: almost all HIV infections among children are due to vertical transmission. In Uruguay, national figures corresponding to vertical transmission are reported by the National Reference Center. There is no information about the way comprehensive healthcare providers of the private sub-sector handle this disease.
Objective: to describe follow-up of children born to HIV infected mothers at Médica Uruguaya to learn about vertical transmission.
Method: the children of HIV infected women who were seen from 2008 through 2011 were included in the study. Maternal and newborn variables were recorded.
Results: there were 26 children born to HIV infected women. Only one infected child was diagnosed in the health facility. Twenty four women had been diagnosed with HIV prior to the birth of their children. All women had been treated with antiretroviral drugs during pregnancy, and received IV zidovudine (AZT) during C-section. Children received oral AZT and were exclusively fed with modified milk. Eighteen children were released from hospital, eight of them are still being followed-up.
Discussion: results obtained at Médica Uruguaya could be explained by the low number of non-controlled pregnancies and the existence of a protocol for healthcare by a multidisciplinary team, which implied close social and biological follow-up of HIV infected women, their families and children.
Conclusions: follow-up starting at early pregnancy and involving partners to improve treatment adherence, check-up visits, and commitment with the newborn care allow for good results in HIV vertical transmission. Breastmilk transmission should be studied.

References

(1) Centers for Disease Control. Pneumocystis pneumonia—Los Angeles. MMWR Morb Mortal Wkly Rep 1981; 30(21):250-2.
(2) Quian J, Gutiérrez S, González V. Virus de la inmunodeficiencia humana y transfusiones: un alerta pediátrico. Arch Pediatr Urug 2011; 82(2):90-2.
(3) Cecchini D, Martínez M, Astarita V, Nieto C, Giesolauro R, Rodríguez C. Prevención de la transmisión vertical del VIH-1 en un hospital público de complejidad terciaria de Buenos Aires, Argentina. Rev Panam Salud Pública 2011; 30(3):189-95.
(4) Comisión Nacional de SIDA. Caracterización epidemiológica de la infección por VIH SIDA en Chile, Diciembre 2003. Rev Chil Infect 2005; 22(2):169-202.
(5) Quian J, Gutiérrez S, Pujadas M, González V, Más M, Parodi A, et al. Hospitalizaciones de niños infectados por el virus de la inmunodeficiencia humana. Arch Pediatr Urug 2008; 79(2):105-12.
(6) Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O’Sullivan MJ, et al; Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 1994; 331(18):1173-80.
(7) Mayaux MJ, Dussaix E, Isopet J, Rekacewicz C, Mandelbrot L, Ciraru-Vigneron N, et al; SEROGEST Cohort Group. Maternal virus load during pregnancy and mother-to-child transmission of human immunodeficiency virus type 1: the French perinatal cohort studies. J Infect Dis 1997; 175(1):172-5.
(8) The European Collaborative Study. Maternal viral load and vertical transmission of HIV-1: an important factor but not the only one. AIDS 1999; 13(11):1377-85.
(9) Quian J, Gutiérrez S, González V, Visconti A, Sicco G, Murialdo C, et al. Prevención de la transmisión materno- infantil del virus inmunodeficiencia humana tipo I en Uruguay 1987-2009: análisis de las diferentes medidas adoptadas. Rev Chil Infect 2012; 29(1):87-94.
(10) Braseli A, Chiparelli H, Dutra A, González A, Mansilla M, Marchese A, et al. Profilaxis y tratamiento de la infección por VIH en pediatría. Montevideo: MSP, 2006. Disponible en: http://www.portalsida.org/repos/sida_pediatricas_ normas.pdf Consulta: diciembre 2013.
(11) Uruguay. Ministerio de Salud Pública. Informe epidemiológico ITS-VIH/Sida, diciembre 2011. Montevideo: MSP, 2011.
(12) Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. Disponible en: http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf Consulta: dic. 2013.
(13) Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Disponible en: http://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf. Consulta: dic. 2013.
(14) Centro Hospitalario Pereira Rossell. Hospital de la Mujer. Sistema Informático Perinatal 2010. Montevideo: CHPR, 2010.
(15) Quian J, Visconti A, Gutiérrez S, Galli A, Maturo M, Galeano V, et al. Detección de infección por VIH a través de test rápido en mujeres embarazadas: una estrategia exitosa para disminuir la transmisión vertical. Rev Chil Infect 2005; 22(4):321-6.
Published
2013-12-31
How to Cite
1.
Más M, Barrios P, Giachetto G, Sayagués B, Morales C, Hernández O. Vertical transmission of human immunodeficiency virus. Rev. Méd. Urug. [Internet]. 2013Dec.31 [cited 2024Nov.24];29(4):232-6. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/266