Transmissão vertical do HIV e características associadas em maternidade pública em Presidente Prudente, Brasil

In children, vertical transmission is the main form of HIV infection. Our aim was to determine the prevalence of HIV-1 vertical transmission in mother-infant pairs in a public maternity ward in Presidente Prudente, SP. Additionally; we sought to identify characteristics associated with this form of transmission. The files of 86 HIV-1-infected mothers and their newborns referred to a Public Hospital from March 2002 to March 2007 were analyzed. The HIV-1-RNA viral load of the newborns was determined by bDNA. The HIV-1 vertical-transmission rate was 4.6%. Children that were born in the pre-term period and breastfed were at a higher risk of HIV-1 infection (p = 0.005 and p = 0.017 respectively) than children born at term and not breastfed. Prophylactic therapy with zidovudine after birth for newborns was associated with a lower risk of infection (p = 0.003). The number of newborns weighing < 2,500 g was significantly higher for infected children (p = 0.008) than for non-infected newborns. About 22.9% of mothers did not know the HIV-1 status of their newborns eight months after delivery. The study suggests that it is necessary to increase the identification of HIV-1 infection in pregnant women and their newborns as well as to offer and explain the benefits of ARV prophylaxis.A transmissão vertical é a principal forma de infecção pelo HIV em crianças. Nosso objetivo foi determinar a prevalência da transmissão vertical do HIV em maternidade pública em Presidente Prudente, SP. Além disso, procuramos identificar características associadas a essa forma de transmissão. De março de 2002 a março de 2007, os prontuários de 86 mães HIV-1 positivo e seus bebês, nascidos na maternidade de Hospital Público foram analisadas. A carga viral do HIV-1-RNA dos recém-nascidos foi determinada por bDNA. A prevalência da transmissão vertical pelo HIV-1 foi de 4,6%. Crianças nascidas a pré-termo e amamentadas tiveram um risco maior de infecção (p = 0,005 e p = 0,017, respectivamente), comparado com crianças nascidas a termo e não amamentadas. A profilaxia com zidovudina depois do nascimento para os recém-nascidos foi associada ao menor risco de infecção (p = 0,003). O número de recém-nascidos com peso < 2.500 g foi maior entre as crianças infectadas (p = 0,008), comparado com crianças não infectadas. Oito meses depois do parto 22,9% das mães não tinham conhecimento da infecção de seus bebês pelo HIV. O presente estudo sugere a necessidade em aumentar a identificação do HIV em gestantes e seus bebês e explicar e oferecer os benefícios da profilaxia antiretroviral

Epidemiology of human immunodeficiency virus-visceral leishmaniasis-co-infection

In Brazil, the rates of mother-to-child-transmission (MTCT) of human immunodeficiency virus (HIV) decreased from 20% to 1-2% in some regions. However, the country contains 90% of individuals infected with visceral leishmaniasis (VL) in Latin America, and the west region of São Paulo state faces an alarming expansion of the disease. We describe the epidemiological aspects of the expanding infection of VL and a case report of an HIV-VL-co-infected child from the west region of São Paulo state. The patient was an AIDS-C3 with low levels of CD4, high viral load, severe diarrhea, oral and perineal candidiasis, severe thrombocytopenia, and protein-caloric malnourishment. She evolved with sepsis, renal and cardiac failure. An rK rapid diagnosis test, indirect fluorescent antibody test (IFAT), and bone marrow aspirate were performed for VL. Her symptoms improved significantly after liposomal amphotericin B administration. From the 45 municipalities that compose the Regional Health Department of Presidente Prudente, Lutzomyia longipalpis vectors were found in 58% of them. VL infected dogs were found in 33% of those municipalities, infected dogs and humans were found in 29%, 20% are starting and 33% of the municipalities are preparing VL investigation. It is likely, in this patient, that VL advanced the clinical progression of the HIV disease and the development of AIDS severity. Supported by favorable conditions, the region becomes a new frontier of VL in Brazil. © 2013

ASSISTÊNCIA MATERNO-INFANTIL DE GESTANTES COM DIAGNÓSTICO DE SÍFILIS EM UMA MATERNIDADE NO INTERIOR DO ESTADO DE SÃO PAULO

The objective of this study is to evaluate the maternal and infant care of pregnant women infected with syphilis. A retrospective cross-sectional study was carried out of syphilis cases in pregnant women treated at a public hospital in the interior of São Paulo who presented a positive rapid test for syphilis at delivery in 2020. The rate of syphilis found during pregnancy was 45.6 per 1000 live births. In total, 82% of the pregnant women who were diagnosed with syphilis during prenatal care received the recommended treatment and 100% of these pregnant women attended at the maternity hospital studied were treated in accordance with the guidelines of the STD/AIDS Reference and Training Center of the Health Department of São Paulo. Regional public health policies should prioritize campaigns to prevent sexually transmitted infections and review prenatal care processes so that all pregnant women infected with syphilis receive the recommended treatment.O objetivo desse estudo é avaliar a assistência materno-infantil de gestantes infectadas com sífilis.Foi realizado um estudo transversal retrospectivo dos casos de sífilis em gestantes atendidas em um hospital público do interior de São Paulo que apresentaram teste rápido positivo para sífilis no momento do parto no ano de 2020. A taxa de sífilis encontrada durante a gestação foi de 45,6 a cada 1000 nascidos vivos. 82% das gestantes que tiveram o diagnóstico de sífilis durante o pré-natal receberam o tratamento preconizado e 100% destas gestantes atendidas na maternidade estudada tiveram o atendimento em conformidade com as diretrizes do Centro de Referência e Treinamento DST/AIDS da Secretaria de Saúde de São Paulo. Políticas de saúde pública regionais devem priorizar as campanhas de prevenção de infecções sexualmente transmissíveis e rever os processos de assistência pré-natal para que toda a gestante infectada com sífilis receba o tratamento preconizado.&nbsp

HIV-1-mother-to-child transmission and associated characteristics in a public maternity unit in Presidente Prudente, Brazil

In children, vertical transmission is the main form of HIV infection. Our aim was to determine the prevalence of HIV-1 vertical transmission in mother-infant pairs in a public maternity ward in Presidente Prudente, SP. Additionally; we sought to identify characteristics associated with this form of transmission. The files of 86 HIV-1-infected mothers and their newborns referred to a Public Hospital from March 2002 to March 2007 were analyzed. The HIV-1-RNA viral load of the newborns was determined by bDNA. The HIV-1 vertical-transmission rate was 4.6%. Children that were born in the pre-term period and breastfed were at a higher risk of HIV-1 infection (p = 0.005 and p = 0.017 respectively) than children born at term and not breastfed. Prophylactic therapy with zidovudine after birth for newborns was associated with a lower risk of infection (p = 0.003). The number of newborns weighing < 2,500 g was significantly higher for infected children (p = 0.008) than for non-infected newborns. About 22.9% of mothers did not know the HIV-1 status of their newborns eight months after delivery. The study suggests that it is necessary to increase the identification of HIV-1 infection in pregnant women and their newborns as well as to offer and explain the benefits of ARV prophylaxis