Evaluation of factors associated with vertical transmission of HIV-1 in fourteen years of a referral center in Southern Brazil

Abstract

Aim: To compare the prevalence and factors associated with vertical transmission of HIV-1 among pregnant women treated in the periods of 1998---2004 and 2005---2011 in a reference service for the care of HIV-infected patients in southern Brazil. Methods: A descriptive and analytical study which used the databases of laboratories of Viral Load and CD4 National Laboratory Network of STD/AIDS, Ministry of Health. HIV-1 infected pregnant women were selected following an active search for clinical information and obstetric and neonatal data from their medical records between the years 1998 and 2011. Results: 102 pregnant women were analyzed between 1998 and 2004 and 251 in the period 2005---2011 totaling 353 children born to pregnant women with HIV-1. It was observed that vertical transmission was 11.8% between 1998 and 2004 and 3.2% between 2005 and 2011 (p < 0.001). The increased use of antiretroviral drugs (p = 0.02), the decrease in viral load (p < 0.001) and time of rupture of membranes lower than 4 h (p < 0.001) were associated with the decrease of vertical transmission factors when comparing the two periods. Conclusion: It was observed a decrease in the rate of vertical transmission in recent years. According to the studied variables, is suggested that the risk factors for vertical transmission of HIV-1 were absence of antiretroviral therapy, high viral load of pregnant women and the breakthrough time greater than 4 h membranes.