HIV rapid testing as a key strategy for prevention of mother-to-child transmission in Brazil

Revista de Saúde Pública

Valdiléa G Veloso²  Francisco I Bastos¹  Margareth Crisóstomo Portela¹  Beatriz Grinsztejn²  Esau Custodio João¹  Jose Henrique Da Silva Pilotto²  Ana Beatriz Busch Araújo¹  Breno Riegel Santos¹  Rosana Campos Da Fonseca¹  Regis Kreitchmann¹  Monica Derrico²  Ruth Khalili Friedman²  Cynthia B Cunha²  Mariza Gonçalves Morgado¹  Karin Nielsen Saines¹  Yvonne J Bryson¹ 

[1] ,Fundação Oswaldo Cruz Instituto de Pesquisa Clínica Evandro Chagas Laboratório de Pesquisa em DST/AIDSRio de Janeiro RJ ,Brasil

关键词: Pregnant Women;    Prenatal Care;    Breast Feeding;    AIDS Serodiagnosis;    HIV Infections;    Infectious Disease Transmission;    Vertical;    Acquired Immunodeficiency Syndrome;    Gestantes;    Cuidado Pré-Natal;    Aleitamento Materno;    Sorodiagnóstico da AIDS;    Infecções por HIV;    Transmissão Vertical de Doença Infecciosa;    Síndrome de Imunodeficiência Adquirida;    Mujeres Embarazadas;    Atención Prenatal;    Lactancia Materna;    Serodiagnóstico del SIDA;    Infecciones por VIH;    Transmisión Vertical de Enfermedad Infecciosa;    Síndrome de Inmunodeficiencia Adquirida;   

DOI  :  10.1590/S0034-89102010005000034

来源: SciELO

【 摘 要 】

OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant women at maternity hospital admission and of subsequent interventions to reduce perinatal HIV transmission. METHODS: Study based on a convenience sample of women unaware of their HIV serostatus when they were admitted to delivery in public maternity hospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 and April 2002. Women were counseled and tested using the Determine HIV1/2 Rapid Test. HIV infection was confirmed using the Brazilian algorithm for HIV infection diagnosis. In utero transmission of HIV was determined using HIV-DNA-PCR. There were performed descriptive analyses of sociodemographic data, number of previous pregnancies and abortions, number of prenatal care visits, timing of HIV testing, HIV rapid test result, neonatal and mother-to-child transmission interventions, by city studied. RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegre and 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women were tested during labor (88.7%), while in Rio de Janeiro most were tested in the postpartum (67.5%). One hundred and forty-four infants were born to 143 HIV-infected women. All newborns but one in each city received at least prophylaxis with oral zidovudine. It was possible to completely avoid newborn exposure to breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio de Janeiro, respectively. Injectable intravenous zidovudine was administered during labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro, respectively. Among those from whom blood samples were collected within 48 hours of birth, in utero transmission of HIV was confirmed in 4 cases in Rio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79). CONCLUSIONS: The strategy proved feasible in maternity hospitals in Rio de Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testing during labor. There is a need of strong social support to provide this population access to health care services after hospital discharge.

【 授权许可】

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