[贝洛奥里藏特大都市区HIV阳性孕妇的先天性和围产期感染患病率]

[Prevalence of congenital and perinatal infection in HIV positive pregnant in Belo Horizonte metropolitan region].

作者信息

Maia Marcelle Marie Martins, Lage Eura Martins, Moreira Bárbara Cecília Borges, Deus Elayne Alayne Braga de, Faria Joanna Gonçalves, Pinto Jorge Andrade, Melo Victor Hugo

机构信息

Grupo de Pesquisa em HIV/Aids Materno/Infantil, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.

Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.

出版信息

Rev Bras Ginecol Obstet. 2015 Sep;37(9):421-7. doi: 10.1590/SO100-720320150005355.

DOI:10.1590/SO100-720320150005355

PMID:26352945

Abstract

PURPOSE

To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors.

METHODS

A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs.

RESULTS

Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis.

CONCLUSIONS

The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.

摘要

目的

评估一组孕妇中弓形虫病、风疹、巨细胞病毒、乙型和丙型肝炎以及梅毒（TORCHs）的感染率，并确定社会人口统计学、临床和实验室因素。

方法

1998年至2013年期间，对巴西一个大都市地区的1573名感染艾滋病毒的孕妇进行了研究。704名（44.8%）孕妇有血清学检测结果。当孕妇至少有一种这些感染的检测结果为阳性时，被认为TORCHs阳性（Gtp）；当所有检测结果均为阴性时，被认为TORCHs阴性（Gtn）。母亲的协变量包括：年龄、婚姻状况、教育水平、感染时间和方式、CD4淋巴细胞计数、分娩时的病毒载量以及抗逆转录病毒疗法（ARV）的使用情况。新生儿的协变量包括：艾滋病毒感染、早产、低出生体重、新生儿并发症、流产和新生儿死亡。使用95%置信区间的比值比来量化母亲和新生儿变量与TORCHs感染之间的关联。

结果

在704名孕妇中，70名（9.9%；95%CI 7.8 - 12.4）的任何TORCHs因子血清学检测呈阳性。各感染的个体感染率分别为：弓形虫病1.5%（10/685）；风疹1.3%（8/618）；巨细胞病毒1.3%（8/597）；乙型肝炎0.9%（6/653）；丙型肝炎3.7%（20/545）；梅毒3.8%（25/664）。Gtp孕妇的艾滋病毒垂直传播率为4.6%，Gtn孕妇为1.2%。在单因素分析中，抗逆转录病毒疗法（ARV）、垂直传播、低出生体重和新生儿并发症与TORCHs阳性显著相关。