Prevención de la transmisión materno-infantil del virus de inmunodeficiencia humana de tipo 1 en Uruguay: 1987-2009. Análisis de las diferentes medidas adoptadas

Abstract

The prevention of vertical transmission (VT) of human immunodeficiency virus (HIV) is a priority as it generally is an avoidable disease. Aim: To describe Uruguay's experience of VT during 23 years and the preventive measures adopted. Patients and Methods: Children of HIV positive mothers born between January 1987 and December 2009 were followed. The mother, pregnancy and children dependent variables were analysed. Infants were classified as infected, not infected, exposed but still in evaluation, or withdrawn of the protocol. The different measures implemented were analyzed. Results: There were 1353 children of HIV positive mothers; 204 (15.1%) infants were infected. The percentage of VT diminished throughout the years; between 2003 and 2009 it decreased to 6%. Protective factors against HIV VT were antiretroviral therapy (ARV) during pregnancy, elective caesarean section and not to nurse the newborn infant. Women who did not receive ARV had a percentage of VT of 50.3 %. Conclusion: The VT has diminished in Uruguay. Special efforts must be done to screen all pregnant women, to improve diagnosis during pregnancy and to implement suitable ARV as occurs in developed countries.