%0 Journal Article
%T Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach
%A Nogueira
%A Susie A.
%A Abreu
%A Thalita
%A Oliveira
%A Ricardo
%A Ara¨²jo
%A L¨²cia
%A Costa
%A Tomaz
%A Andrade
%A Miriam
%A Psic
%A M. F¨¢tima Garcia
%A Machado
%A Elizabeth
%A Rodrigues
%A K¨¢ris
%A Mercadante
%A Elizabeth Regina
%A Fernandes
%A Ira¨ªna
%A Sapia
%A M. Concei£¿£¿o
%A Lambert
%A John S.
%J Brazilian Journal of Infectious Diseases
%D 2001
%I Brazilian Society of Infectious Diseases
%R 10.1590/S1413-86702001000200006
%X objectives: to determine the hiv vertical transmission rate (vtr) and associated risk factors by use of zidovudine and infant care education in brazil. methods: since 1995, a prospective cohort of hiv infected pregnant women has been followed at the federal university of rio de janeiro. a multidisciplinary team was established to implement the best available strategy to prevent maternal-infant hiv transmission. patients with aids or low cd4 and high viral load received anti-retroviral drugs in addition to zidovudine. children were considered infected if they had 2 positive pcr-rna tests between 1 and 4 months of age, or were hiv antibody positive after 18 months. education regarding infant treatment and use of formula instead of breast feeding was provided. results: between 1995 and august, 2000, hiv status was determined for 145 infants. compliance with intra-partum treatment, infant treatment and use of formula was 88.2%. intra-partum zidovudine treatment was completed in 134/145 (92.6%) of patients; 88.1% had rupture of membranes < 4 hours; 85.4% of mothers were asymptomatic. the mean cd4 count was 428.4 cells and mean viral load 39,050 copies. hiv vertical transmission rate was 4/145 (2.75%; ci: 0.1%-5.4%). the only risk factor significantly associated with transmission was a failure to use zidovudine intra-partum in 2 of the 4 mothers (50% versus 6.4% in non-transmitting mothers). a trend toward low cd4 and high viral load at entry, and rupture of membranes > 4 hours were associated with increased hiv transmission. conclusion: hiv vertical transmission in brazil was reduced to a level similar to other countries with the most effective prevention programs using a multidisciplinary team approach. a high level of compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants.
%K brazil
%K hiv
%K prevention
%K perinatal transmission
%K zidovudine.
%U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S1413-86702001000200006&lng=en&nrm=iso&tlng=en