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巴西萨尔瓦多-巴伊亚地区产妇人类免疫缺陷病毒、人类嗜 T 淋巴细胞病毒和乙型/丙型肝炎感染的血清流行率及相关因素分析。

Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador - Bahia, Brazil.

机构信息

Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil; Universidad Pedagógica y Tecnológica de Colombia, Boyacá, Colombia.

Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil.

出版信息

Braz J Infect Dis. 2020 Jul-Aug;24(4):279-287. doi: 10.1016/j.bjid.2020.05.001. Epub 2020 May 25.

Abstract

BACKGROUND

The heterogeneity in detection rates of Human immunodeficiency virus, (HIV), Human T lymphotropic virus (HTLV) and Hepatitis B and C infections among pregnant women and the continuous exposure to risk factors limits the adoption of preventive and control actions.

OBJECTIVE

To evaluate the HIV, HTLV, Hepatitis B and C seroprevalence rates, and associated risk factors in parturient women in Salvador, Brazil.

METHODS

This was a cross-sectional study in 2099 parturient women attended in two public maternity hospitals in Salvador, Brazil. One blood sample was drawn for serological screening and socio-demographic, obstetric and clinical data were collected.

RESULTS

HIV seroprevalence rate was 1.5% (of which 0.6% were new cases); seroprevalence rates for HTLV, HBV, and HCV were 0.4%, 0.4%, and 0.1%, respectively. Univariate analysis showed a significant association between socio-demographic and behavioral factors with retroviral infections, while viral hepatitis was mainly associated with parenteral exposure. In a multivariate analysis, multiple sexual partners (OR 3.3; 95% CI: 1.1-9.2), history of sexual/domestic violence (OR 2.8; 95% CI: 1.1-6.9), syphilis co-infection (OR 2.6; 95% CI: 1.0-6.9), use of alcohol or drugs (OR 2.5; 95% CI: 1.2-5.5), and low schooling level (OR 2.3; 95% CI: 1.1-4.9) were independent risk factors for HIV infection. History of stillbirth and low birth weight infants was significantly associated with HTLV positive status, showing a negative impact on gestation.

CONCLUSIONS

The seroprevalence rates for HIV, HCV, HBV, and HTLV were similar to that found in previous studies in other Brazilian regions. The high individual, socioeconomic, and social vulnerability detected in seropositive parturient women indicates the need to improve coverage and effectiveveness of STDs control with prevention, detection and monitoring strategies, focusing in pregnant women exposed to high biopsychosocial risk.

摘要

背景

在孕妇中,人类免疫缺陷病毒(HIV)、人类 T 淋巴细胞病毒(HTLV)和乙型肝炎与丙型肝炎感染的检出率存在差异,且持续接触危险因素,这限制了预防和控制措施的采取。

目的

评估巴西萨尔瓦多的产妇中 HIV、HTLV、乙型肝炎和丙型肝炎的血清流行率及其相关危险因素。

方法

这是一项在巴西萨尔瓦多的两家公立医院就诊的 2099 名产妇中进行的横断面研究。采集一份血样进行血清学筛查,并收集社会人口学、产科和临床数据。

结果

HIV 的血清流行率为 1.5%(其中 0.6%为新发病例);HTLV、HBV 和 HCV 的血清流行率分别为 0.4%、0.4%和 0.1%。单因素分析显示,社会人口学和行为因素与逆转录病毒感染显著相关,而病毒性肝炎主要与注射暴露相关。在多因素分析中,多个性伴侣(OR 3.3;95%CI:1.1-9.2)、性/家庭暴力史(OR 2.8;95%CI:1.1-6.9)、梅毒合并感染(OR 2.6;95%CI:1.0-6.9)、使用酒精或毒品(OR 2.5;95%CI:1.2-5.5)和低教育水平(OR 2.3;95%CI:1.1-4.9)是 HIV 感染的独立危险因素。死产和低出生体重儿史与 HTLV 阳性状态显著相关,对妊娠有负面影响。

结论

HIV、HCV、HBV 和 HTLV 的血清流行率与巴西其他地区的既往研究相似。在血清阳性产妇中发现的个人、社会经济和社会脆弱性较高,表明需要通过预防、检测和监测策略,改善性传播疾病控制的覆盖面和有效性,重点关注处于高生物心理社会风险中的孕妇。

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