Missed opportunities for prevention of mother-to-child transmission of HIV-1 in the NISDI Perinatal and LILAC cohorts
| Contribuinte(s) |
UNIVERSIDADE DE SÃO PAULO |
|---|---|
| Data(s) |
11/09/2013
11/09/2013
2012
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| Resumo |
Objective: To evaluate cases of mother-to-child transmission of HIV-1 at multiple sites in Latin America and the Caribbean in terms of missed opportunities for prevention. Methods: Pregnant women infected with HIV-1 were eligible for inclusion if they were enrolled in either the NISDI Perinatal or LILAC protocols by October 20, 2009, and had delivered a live infant with known HIV-1 infection status after March 1, 2006. Results: Of 711 eligible mothers, 10 delivered infants infected with HIV-1. The transmission rate was 1.4% (95% CI, 0.7-2.6). Timing of transmission was in utero or intrapartum (n = 5), intrapartum (n = 2), intrapartum or early postnatal (n = 1), and unknown (n = 2). Possible missed opportunities for prevention included poor control of maternal viral load during pregnancy; late initiation of antiretrovirals during pregnancy; lack of cesarean delivery before labor and before rupture of membranes; late diagnosis of HIV-1 infection; lack of intrapartum antiretrovirals; and incomplete avoidance of breastfeeding. Conclusion: Early knowledge of HIV-1 infection status (ideally before or in early pregnancy) would aid timely initiation of antiretroviral treatment and strategies designed to prevent mother-to-child transmission. Use of antiretrovirals must be appropriately monitored in terms of adherence and drug resistance. If feasible, breastfeeding should be completely avoided. Presented in part at the XIX International AIDS Conference (Washington, DC; July 22-27, 2012); abstract WEPE163. (c) 2012 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. National Institute of Child Health and Human Development (NICHD) [N01-HD-3-3345] National Institute of Child Health and Human Development (NICHD) National Institute of Child Health and Human Development (NICHD)[HHSN267200800001C, N01-HD-8-0001] National Institute of Child Health and Human Development (NICHD) |
| Identificador |
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, Clare, v. 119, n. 1, pp. 70-75, OCT, 2012 0020-7292 http://www.producao.usp.br/handle/BDPI/33252 10.1016/j.ijgo.2012.05.026 |
| Idioma(s) |
eng |
| Publicador |
ELSEVIER IRELAND LTD Clare |
| Relação |
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS |
| Direitos |
closedAccess Copyright ELSEVIER IRELAND LTD |
| Palavras-Chave | #HIV-1 #MOTHER-TO-CHILD TRANSMISSION #PREVENTION #IMMUNODEFICIENCY-VIRUS TYPE-1 #RISK-FACTORS #PREGNANCY #TRANSMISSÃO VERTICAL #INFECTIOUS DISEASES VERTICAL TRANSMISSION #HIV #INFECÇÃO POR HIV #GRAVIDEZ #PREVENÇÃO DE DOENÇAS #OBSTETRICS & GYNECOLOGY |
| Tipo |
article original article publishedVersion |
