Turchi Marília Dalva, Duarte Lucélia da Silva, Martelli Celina Maria Turchi
Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil.
Cad Saude Publica. 2007;23 Suppl 3:S390-401. doi: 10.1590/s0102-311x2007001500007.
The objectives of this study were to estimate the risk of vertical HIV transmission and assess the associated factors and missed opportunities for prevention in a cohort of HIV+ pregnant women (1995-2001) treated in Goiânia, Goiás, Brazil, with follow-up of their children until 2005. Three data sources were compared: Information System on Reportable Diseases (SINAN), Information System on HIV+ Pregnant Women and Exposed Children (SISGHIV), and patient clinical charts. The study estimated the vertical transmission rates, factors associated with vertical transmission, and use of antiretroviral therapy. 276 HIV+ women were identified (322 pregnancies), and there were 70 HIV+ children. Overall risk of vertical HIV transmission was 27.8%. The vertical transmission rate was 40.8% in the group without prophylaxis and 1% in the group with adequate prophylaxis, i.e., a 97.5% reduction in transmission risk. Year of delivery, consultation with a specialist, and no history of injecting drug use were factors associated with adequate use of antiretroviral therapy. The study showed an important reduction in the risk of vertical transmission in pregnant women who received adequate therapy, besides identifying missed opportunities for prevention.
本研究的目的是估计巴西戈亚斯州戈亚尼亚市接受治疗的一组HIV阳性孕妇（1995 - 2001年）垂直传播HIV的风险，评估相关因素以及预防方面的错失机会，并对其子女随访至2005年。比较了三个数据来源：法定传染病信息系统（SINAN）、HIV阳性孕妇及暴露儿童信息系统（SISGHIV）和患者临床病历。该研究估计了垂直传播率、与垂直传播相关的因素以及抗逆转录病毒疗法的使用情况。共识别出276名HIV阳性女性（322次妊娠），并有70名HIV阳性儿童。HIV垂直传播的总体风险为27.8%。未进行预防措施组的垂直传播率为40.8%，而采取充分预防措施组的垂直传播率为1%，即传播风险降低了97.5%。分娩年份、咨询专科医生以及无注射吸毒史是与充分使用抗逆转录病毒疗法相关的因素。该研究表明，接受充分治疗的孕妇垂直传播风险显著降低，此外还识别出了预防方面的错失机会。
