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AIDS and Behavior

, Volume 22, Supplement 1, pp 92–98 | Cite as

Factors Associated with Maternal-Child Transmission of HIV-1 in Southeastern Brazil: A Retrospective Study

  • Thiago Nascimento do Prado
  • Deborah Bain Brickley
  • Nancy K. Hills
  • Eliana Zandonade
  • Sandra Fagundes Moreira-Silva
  • Angélica Espinosa Miranda
Original Paper

Abstract

Mother-to-child transmission (MTCT) is the main mode of HIV-1 acquisition among young children worldwide. The goals of this study were to estimate the proportion of HIV MTCT and to identify factors associated with transmission. We reviewed data for HIV-infected pregnant women that had been reported to the National Information on Reportable Diseases System (SINAN) in Espírito Santo state, Brazil, between January 2007 and December 2012. HIV cases in children were followed until age 18 months. The proportion of women who transmitted HIV to their babies was 14% (95% CI 11–17%). In a multivariate logistic regression model, pregnant women who had lower than primary school education (OR 2.74; 95% CI 1.31–5.71), had 2 or more pregnancies during the study period (OR 2.28; 95% CI 1.07–4.84), had emergency cesarean delivery (OR 4.32; 95% CI 1.57–11.9), and did not receive antiretroviral therapy during prenatal care (OR 2.41; 95% CI 1.09–5.31) had higher odds of HIV MTCT. Effort should be made to encourage health care workers and pregnant women to use services for the prevention of MTCT.

Keywords

Infectious disease transmission Vertical transmission HIV Pregnancy Retrospective studies 

Resumen

La transmisión materno-infantil (TMI) es el principal modo de adquisición del VIH-1 entre los niños de todo el mundo. Los objetivos del estudio fueron estimar la tasa de TMI del VIH e identificar los factores asociados. Se realizó una revisión de los datos de mujeres embarazadas infectadas por el VIH notificadas al Sistema Nacional de Información sobre Enfermedades Reportables (SINAN) en el estado de Espírito Santo/Brasil, entre enero de 2007 y diciembre de 2012. Los casos de VIH en niños fueron seguidos hasta 18 meses. La proporción de TMI fue del 14% (IC95%:10,9-17,0). En el modelo de regresión logística multivariable, las mujeres embarazadas que tenían menos que la educación primaria (OR = 2,74; IC del 95%: 1,31-5,71), que tuvieron dos o más embarazos durante el estudio del período (OR = 2,28; 95% IC 1,07-4,84), que tuvieron el parto por cesárea de emergencia (OR = 4,32; IC95%:1,57-11,9) y las mujeres embarazadas que no recibieron tratamiento antirretroviral durante la atención prenatal (OR = 2,41; IC95%:1,09-5,31) tuvieron mayor probabilidad de TMI. Deberían realizarse esfuerzos para alentar a los trabajadores sanitarios ya las mujeres embarazadas a que utilicen los servicios de PTMI.

Palabras claves

Transmisión de enfermedades infecciosas Transmisión vertical VIH Embarazo Estudios retrospectivos 

Notes

Acknowledgements

We wish to acknowledge support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712 and the Starr Foundation Scholarship Fund. In addition, we wish to acknowledge support from the Brazilian Ministry of Health, National Foundation of Health. Grant # Termo de 323/2014.

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from individual participants included in the study.

References

  1. 1.
    Joint United Nations Programme on HIV/AIDS (UNAIDS). Global HIV/AIDS response: epidemic update and health sector progress towards universal access, progress report 2011. UNAIDS, 2011.Google Scholar
  2. 2.
    Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Boletim Epidemiológico—Aids e DST. Ano V—nº 1. Brasília: Ministério da Saúde, 2016. http://www.aids.gov.br/pt-br/pub/2016/boletim-epidemiologico-de-aids-2016. Accessed 20 Sept 2017.
  3. 3.
    Szwarcwald CL, Barbosa Junior A, Souza-Junior PR, et al. HIV testing during pregnancy: use of secondary data to estimate 2006 test coverage and prevalence in Brazil. Braz J Infect Dis. 2008;2:167–72.Google Scholar
  4. 4.
    Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de DST e Aids. Protocolo Clínico e Diretrizes Terapêuticas para Prevenção da Transmissão Vertical de HIV, Sífilis e Hepatites Virais. Brasília: Ministério da Saúde; 2016. http://www.aids.gov.br/pt-br/pub/2015/protocolo-clinico-e-diretrizes-terapeuticas-para-prevencao-da-transmissao-vertical-de-hiv. Accessed 18 Oct 2017.
  5. 5.
    Joint United Nations Programme on HIV/AIDS (UNAIDS). 2015 Progress report on the global plan towards the elimination of new HIV infections among children and keeping their mothers alive. UNAIDS, 2015.Google Scholar
  6. 6.
    Tess BH, Rodrigues LC, Newell ML, Dunn DT, Lago TD. Infant feeding and risk of mother-to-child transmission of HIV-1 in São Paulo State, Brazil. São Paulo collaborative study for vertical transmission of HIV-1. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;19:189–94.CrossRefPubMedGoogle Scholar
  7. 7.
    Nogueira SA, Abreu T, Oliveira R, et al. Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach. Braz J Infect Dis. 2001;5:78–86.CrossRefPubMedGoogle Scholar
  8. 8.
    João EC, Cruz ML, Menezes JA, et al. Vertical transmission of HIV in Rio de Janeiro, Brazil. AIDS. 2003;17:1853–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Mussi-Pinhata MM, Kato CM, Duarte G, Paschoini MC, Bettiol H, Quintana SM. Factors associated with vertical HIV transmission during two different time periods: the impact of zidovudine use on clinical practice at a Brazilian reference center. Int J STD AIDS. 2003;14:818–25.CrossRefPubMedGoogle Scholar
  10. 10.
    Fernandes RC, Araújo LC, Medina-Acosta E. Prevention of vertical HIV transmission in Campos dos Goytacazes, Rio de Janeiro, Brazil. Cad Saúde Pública. 2005;21:1153–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Miranda AE, Soares RA, Prado BC, Monteiro RB, Figueiredo NC. Mother to child transmission of HIV in Vitória, Brazil: factors associated with lack of HIV prevention. AIDS Care. 2005;17:721–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Kakehasi FM, Pinto JA, Romanelli RM, et al. Determinants and trends in perinatal human immunodeficiency vírus type 1 (HIV-1) transmission in the metropolitan area of Belo Horizonte, Brazil: 1998–2005. Mem Inst Oswaldo Cruz. 2008;103:351–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Dal Fabbro MM, Cunha RV, Paniago AM, Lindenberg AS, Freitas GM, Nogueira SA. Prospective study on the prevention of vertical transmission of HIV in Campo Grande, Mato Grosso do Sul, Brazil, from 1996 to 2001. Braz J Infect Dis. 2005;9:20–7.CrossRefGoogle Scholar
  14. 14.
    Torres SR, Luz AMH. HIV+ pregnant woman and exposed children: epidemiological study on compulsory notification. Rev Gauch Enferm. 2007;28:505–11.Google Scholar
  15. 15.
    de Lemos LM, Lippi J, Rutherford GW, et al. Maternal risk factors for HIV infection in infants in northeastern Brazil. Int J Infect Dis. 2013;17(10):e913–8.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Pan American Health Organization (PAHO). Elimination of mother-to-child transmission of HIV and syphilis in the Americas. Update 2016. Washington, DC: PAHO; 2017. http://iris.paho.org/xmlui/bitstream/handle/123456789/34072/9789275119556-eng.pdf?sequence=4&isAllowed=y. Accessed 04 Dec 2017.
  17. 17.
    Gulland A. Cuba is first country to eliminate mother to child HIV transmission. BMJ. 2015;351:h3607.CrossRefPubMedGoogle Scholar
  18. 18.
    Menezes Succi RC. Mother-to-child transmission of HIV in Brazil during the years 2000 and 2001: results of a multi-centric study. Cad Saúde Pública. 2007;23(3):379–89.CrossRefGoogle Scholar
  19. 19.
    Vieira ACBC, Miranda AE, Vargas PRM, Maciel ELN. Prevalência de HIV em gestantes e transmissão vertical segundo perfil socioeconômico, Vitória, ES. Rev Saúde Pública. 2011;45(4):644–51.CrossRefPubMedGoogle Scholar
  20. 20.
    Cerqueira ACB, Sales CMM, Lima R, et al. Completude do sistema de informação de agravos de notificação compulsória de gestante HIV positivo entre 2001 e 2006, no Espírito Santo, Brasil. UFES Rev Odont. 2008;10(1):33–7.Google Scholar
  21. 21.
    Instituto Brasileiro de Geografia e Estatística. Senso 2010. Espirito Santo. Brazil: Instituto Brasileiro de Geografia e Estatística; 2010. http://cod.ibge.gov.br/96J. Accessed 12 May 2016.
  22. 22.
    Forbes JC, Alimenti AM, Singer J, et al. A national review of vertical HIV transmission. AIDS. 2012;26(6):757–63.CrossRefPubMedGoogle Scholar
  23. 23.
    Duong T, Ades AE, Gibb DM, Tookey PA, Masters J. Vertical transmission rates for HIV in the British Isles: estimates based on surveillance data. BMJ. 1999;319:1227–9.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lindegren M, Byers RH, Thomas P, et al. Trends in perinatal transmission of HIV/AIDS in the United States. JAMA. 1999;282:531–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Lopes F, Buchalla M, Ayres JRCM. Mulheres negras e não-negras e vulnerabilidade ao HIV/Aids no estado de São Paulo, Brasil. Rev Saúde Pública. 2007;41(suppl 2):39–46.CrossRefPubMedGoogle Scholar
  26. 26.
    Isono WL, Nagamatsu T, Uemura Y, et al. Prediction model for the incidence of emergent cesarean section during induction of labor specialized in nulliparous low-risk women. J Obstet Gynaecol Res. 2011;37(12):1784–91.CrossRefPubMedGoogle Scholar
  27. 27.
    Santos Neto ET, Oliveira AE, Zandonade E, Gama SGN, Leal MC. O que os cartões de pré-natal das gestantes revelam sobre a assistência nos serviços do SUS da Região Metropolitana da Grande Vitória, Espírito Santo, Brasil? Cad Saúde Pública. 2012;28(9):1650–62.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Thiago Nascimento do Prado
    • 1
    • 2
  • Deborah Bain Brickley
    • 3
  • Nancy K. Hills
    • 3
  • Eliana Zandonade
    • 2
  • Sandra Fagundes Moreira-Silva
    • 4
  • Angélica Espinosa Miranda
    • 2
    • 5
  1. 1.Department of NursingFederal University of Espírito SantoVitóriaBrazil
  2. 2.Post-Graduate Program in Public HealthFederal University of Espírito SantoVitóriaBrazil
  3. 3.Global Health SciencesUniversity of CaliforniaSan FranciscoUSA
  4. 4.Serviço de InfectologiaHospital Infantil Nossa Senhora da GlóriaVitóriaBrazil
  5. 5.Post-Graduate Program in Infectious DiseasesFederal University of Espírito SantoVitóriaBrazil

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