TITLE

STUDIU RETROSPECTIV AL FACTORILOR DE RISC AI INFECŢIEI HIV-1 LA O COHORTĂ DE GRAVIDE INFECTATE ŞI NOU-NĂSCUŢI DIN SPITALUL CLINIC DE BOLI INFECŢIOASE ŞI TROPICALE „R. VICTOR BABEŞ“ BUCUREŞTI

AUTHOR(S)
Muila, Andre; Georgescu, Adrian
PUB. DATE
August 2009
SOURCE
Romanian Journal of Infectious Diseases;2009, Vol. 12 Issue 3, p130
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
In 1994, it was showed that an antiretroviral regime based on zidovudine administered during pregnancy, labor and to the new born, reduced the mother to child transmission rate of HIV by 67 % (1). In developed countries, vertical transmission of HIV has decreased to less than 2% because the majority of infected women receive HAART, are counseled for a scheduled cesarean section and formula feeding is available. We have evaluated the MTC rate, associated risk factors and the efficacy of prophylactic measures in a retrospective observational study (Jan 2004 - Apr 2008), in which we have included 30 HIV infected pregnant women and 34 children born by these mothers, in "Dr. Victor Babes" Clinical Hospital for Infectious and Tropical Diseases, Bucharest, Romania. Data has been processed using the chi-square and Fisher exact tests as well as the Mann Whitney analysis. As regards the HIV infection we have used ELISA HIV1+2, Western blot HIV-1, PCR RNA-HIV-1 tests and CD4 count. The median age of the 30 patients was 23y (17-36y). Eighteen children were males (54%) and 12 were females (46%). The overall HIV transmission rate was 26,4 (9/34). For the 11 paired mothers and children who underwent complete prophylaxis measures (with or without scheduled C-section), the transmission rate was zero. Twentysix (78%) babies were full term, but prematurity was associated with the HIV infection of the children (p < 0.01, OR=6.50). Most babies (20) were born with a normal birth weight (2800-3800g), but low birth weight in the subgroup of the full term children was found to be associated with their HIV infected status (p<0.05, OR=3.33). The lack of ARV prophylaxis for the mothers who delivered naturally was associated with the HIV transmission to the children (p<0.04, OR=5). Most of the infected children were a part of the breastfed group (7/12, 59%, p<0.01, OR=6.42) and it was shown that the mothers' prematurely ruptured membranes was associated with HIV transmission (p<0.01, OR=4.64). Zidovudine prophylaxis during labor (orally) was found to be protective against having an infected child (p<0.05) and giving ARV prophylaxis to the child from birth was associated with a lower risk of transmission (p<0.01). The mothers' viral loads in the last month of pregnancy were higher for those who gave birth to infected children as compared to those who delivered healthy ones (170296c/ml vs 800c/ml)(p<0.01). We found no difference between the median CD4 count amongst these two groups (p=ns). For the mothers who didn't undergo full prophylaxis or didn't receive any, the transmission rate was high while for the group of those who had complete prophylaxis it was zero. Prematurity, low birth weight in the group of the full term babies, natural birth or through emergency Csection, early rupture of the membranes, breastfeeding and high values of the HIV viral load in the last month of pregnancy were found to be risk factors for acquiring HIV through MTC transmission.
ACCESSION #
51336836

 

Related Articles

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics