Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004
Autor(a) principal: | |
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Data de Publicação: | 2007 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista brasileira de epidemiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2007000300004 |
Resumo: | OBJECTIVE: To describe trends in sociodemographic, immunological and virological profiles and interventions to decrease the risk of mother-to-child HIV transmission. METHODS: Retrospective cohort study conducted at a tertiary institution in Rio de Janeiro, Brazil from January 1996 to December 2004. Analysis was performed by stratification in three time periods: 1996-1998 (P1), 1999-2001 (P2) and 2002-2004 (P3). RESULTS: In 9 years, 622 pregnancies occurred. Complications included: maternal mortality 0.3%, stillbirths 2.5%, miscarriages 0.6%, neonatal mortality 1.1%, prematurity 9.9%, low birth weight (LBW) 16.5%, congenital malformations 2.2%. The number of HIV-infected pregnant patients grew threefold over time reflecting increased prevalence of disease and patient identification. HIV diagnosis before pregnancy increased from 30% in P1 to 45% in P3. The proportion of pregnant women receiving highly active antiretroviral therapy increased from none (P1) to 88% (P3) with a significant trend towards women delivering at undetectable viral loads in later years despite a higher frequency of advanced disease. Scheduled cesarean deliveries increased from 35% in P1 to 48% in P3. Perinatal transmission rates were 2.4% with a decline from 3.5% in P1 to 1.6% in P3. Neonatal outcomes tended to remain constant or improve with time. A slight rise in LBW and congenital malformations were observed. CONCLUSIONS: During the observational period, HIV+ pregnant women presented with more advanced disease and lower socio-economic status. However, improved management of HIV-infected patients (associated with increased identification and increased availability of treatment) resulted into very low transmission rates similar to those of developed countries with overall improvement of patient outcomes. |
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Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004Mother-to-child HIV transmissionAntiretroviral therapy pregnancyCohort study BrazilHIVOBJECTIVE: To describe trends in sociodemographic, immunological and virological profiles and interventions to decrease the risk of mother-to-child HIV transmission. METHODS: Retrospective cohort study conducted at a tertiary institution in Rio de Janeiro, Brazil from January 1996 to December 2004. Analysis was performed by stratification in three time periods: 1996-1998 (P1), 1999-2001 (P2) and 2002-2004 (P3). RESULTS: In 9 years, 622 pregnancies occurred. Complications included: maternal mortality 0.3%, stillbirths 2.5%, miscarriages 0.6%, neonatal mortality 1.1%, prematurity 9.9%, low birth weight (LBW) 16.5%, congenital malformations 2.2%. The number of HIV-infected pregnant patients grew threefold over time reflecting increased prevalence of disease and patient identification. HIV diagnosis before pregnancy increased from 30% in P1 to 45% in P3. The proportion of pregnant women receiving highly active antiretroviral therapy increased from none (P1) to 88% (P3) with a significant trend towards women delivering at undetectable viral loads in later years despite a higher frequency of advanced disease. Scheduled cesarean deliveries increased from 35% in P1 to 48% in P3. Perinatal transmission rates were 2.4% with a decline from 3.5% in P1 to 1.6% in P3. Neonatal outcomes tended to remain constant or improve with time. A slight rise in LBW and congenital malformations were observed. CONCLUSIONS: During the observational period, HIV+ pregnant women presented with more advanced disease and lower socio-economic status. However, improved management of HIV-infected patients (associated with increased identification and increased availability of treatment) resulted into very low transmission rates similar to those of developed countries with overall improvement of patient outcomes.Associação Brasileira de Saúde Coletiva2007-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2007000300004Revista Brasileira de Epidemiologia v.10 n.3 2007reponame:Revista brasileira de epidemiologia (Online)instname:Associação Brasileira de Saúde Coletiva (ABRASCO)instacron:ABRASCO10.1590/S1415-790X2007000300004info:eu-repo/semantics/openAccessCalvet,Guilherme AmaralJoão,Esaú CustódioNielsen-Saines,KarinCunha,Cynthia BragaMenezes,Jacqueline Anitad'Ippolito,Marcos MachadoCruz,Maria Letícia SantosMartins,Ezequias BatistaSilva,Sônia Maria SantosMedeiros,Adriana FerreiraMatos,Haroldo Joséeng2007-09-17T00:00:00Zoai:scielo:S1415-790X2007000300004Revistahttp://www.scielo.br/rbepidhttps://old.scielo.br/oai/scielo-oai.php||revbrepi@usp.br1980-54971415-790Xopendoar:2007-09-17T00:00Revista brasileira de epidemiologia (Online) - Associação Brasileira de Saúde Coletiva (ABRASCO)false |
dc.title.none.fl_str_mv |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
title |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
spellingShingle |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 Calvet,Guilherme Amaral Mother-to-child HIV transmission Antiretroviral therapy pregnancy Cohort study Brazil HIV |
title_short |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
title_full |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
title_fullStr |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
title_full_unstemmed |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
title_sort |
Trends in a Cohort of HIV-infected pregnant women in Rio de Janeiro, 1996-2004 |
author |
Calvet,Guilherme Amaral |
author_facet |
Calvet,Guilherme Amaral João,Esaú Custódio Nielsen-Saines,Karin Cunha,Cynthia Braga Menezes,Jacqueline Anita d'Ippolito,Marcos Machado Cruz,Maria Letícia Santos Martins,Ezequias Batista Silva,Sônia Maria Santos Medeiros,Adriana Ferreira Matos,Haroldo José |
author_role |
author |
author2 |
João,Esaú Custódio Nielsen-Saines,Karin Cunha,Cynthia Braga Menezes,Jacqueline Anita d'Ippolito,Marcos Machado Cruz,Maria Letícia Santos Martins,Ezequias Batista Silva,Sônia Maria Santos Medeiros,Adriana Ferreira Matos,Haroldo José |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Calvet,Guilherme Amaral João,Esaú Custódio Nielsen-Saines,Karin Cunha,Cynthia Braga Menezes,Jacqueline Anita d'Ippolito,Marcos Machado Cruz,Maria Letícia Santos Martins,Ezequias Batista Silva,Sônia Maria Santos Medeiros,Adriana Ferreira Matos,Haroldo José |
dc.subject.por.fl_str_mv |
Mother-to-child HIV transmission Antiretroviral therapy pregnancy Cohort study Brazil HIV |
topic |
Mother-to-child HIV transmission Antiretroviral therapy pregnancy Cohort study Brazil HIV |
description |
OBJECTIVE: To describe trends in sociodemographic, immunological and virological profiles and interventions to decrease the risk of mother-to-child HIV transmission. METHODS: Retrospective cohort study conducted at a tertiary institution in Rio de Janeiro, Brazil from January 1996 to December 2004. Analysis was performed by stratification in three time periods: 1996-1998 (P1), 1999-2001 (P2) and 2002-2004 (P3). RESULTS: In 9 years, 622 pregnancies occurred. Complications included: maternal mortality 0.3%, stillbirths 2.5%, miscarriages 0.6%, neonatal mortality 1.1%, prematurity 9.9%, low birth weight (LBW) 16.5%, congenital malformations 2.2%. The number of HIV-infected pregnant patients grew threefold over time reflecting increased prevalence of disease and patient identification. HIV diagnosis before pregnancy increased from 30% in P1 to 45% in P3. The proportion of pregnant women receiving highly active antiretroviral therapy increased from none (P1) to 88% (P3) with a significant trend towards women delivering at undetectable viral loads in later years despite a higher frequency of advanced disease. Scheduled cesarean deliveries increased from 35% in P1 to 48% in P3. Perinatal transmission rates were 2.4% with a decline from 3.5% in P1 to 1.6% in P3. Neonatal outcomes tended to remain constant or improve with time. A slight rise in LBW and congenital malformations were observed. CONCLUSIONS: During the observational period, HIV+ pregnant women presented with more advanced disease and lower socio-economic status. However, improved management of HIV-infected patients (associated with increased identification and increased availability of treatment) resulted into very low transmission rates similar to those of developed countries with overall improvement of patient outcomes. |
publishDate |
2007 |
dc.date.none.fl_str_mv |
2007-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2007000300004 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2007000300004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1415-790X2007000300004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Brasileira de Saúde Coletiva |
publisher.none.fl_str_mv |
Associação Brasileira de Saúde Coletiva |
dc.source.none.fl_str_mv |
Revista Brasileira de Epidemiologia v.10 n.3 2007 reponame:Revista brasileira de epidemiologia (Online) instname:Associação Brasileira de Saúde Coletiva (ABRASCO) instacron:ABRASCO |
instname_str |
Associação Brasileira de Saúde Coletiva (ABRASCO) |
instacron_str |
ABRASCO |
institution |
ABRASCO |
reponame_str |
Revista brasileira de epidemiologia (Online) |
collection |
Revista brasileira de epidemiologia (Online) |
repository.name.fl_str_mv |
Revista brasileira de epidemiologia (Online) - Associação Brasileira de Saúde Coletiva (ABRASCO) |
repository.mail.fl_str_mv |
||revbrepi@usp.br |
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1754212951144792064 |