The purpose of the study was to estimate rates of
mother-to-child transmission (MTCT) of HIV in the Amazonas state, Brazil, and
to identify the associated factors.
This was a retrospective cohort study of 1210 children born
to HIV-infected women between 1999 and 2011 and enrolled before age of 18
months in a reference HIV/AIDS pediatrics service in Manaus. We used
multivariable logistic regression to assess the effect of maternal, obstetric,
and prophylactic interventions on MTCT of HIV.
Ten children were excluded due to undocumented maternal
HIV-status. Among 1200 children, 163 (13.6%) were lost to follow-up (LTFU). We
included in the analysis 1037 children with known HIV-status. Of those, 68
children were HIV-infected, resulting in a MTCT rate of 6.6%.
Among mothers, 76.1% had received antiretroviral therapy (ART) during
pregnancy, 59.3% elective caesarean, and 9.7% were breastfed. Factors associated
with lower odds of MTCT of HIV were: ART during pregnancy, elective caesarean, and with MTCT: being breastfed. Transmission decreased from 7.5% in 2007-2008 to 3.2% in 2011 while
breastfeeding decreased from 30.8% in 1999-2000 to 3.9% in 2011-2012.
The HIV rate of MTCT is still high in the Amazonas and
challenges for its prevention prevail including LTFU and gaps in critical
strategies such as antiretroviral use during pregnancy. More efforts are needed
to increase the number of women and babies who successfully complete the
prevention of MTCT cascade and work towards elimination of MTCT of HIV.
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By:
- 11. Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas State, Brazil 2. Universidade do Estado do Amazonas, Manaus, Amazonas State, Brazil 3. TransLab. Departament of Medical Sciences. Faculty of Medicine. Universitat de Girona, Catalunya. 4. Departamento de DST, Aids e Hepatites Virais, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brazil.
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