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- ItemAcesso aberto (Open Access)AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2007-01-01) Matida, Luiza Harunari [UNIFESP]; Ramos Junior, Alberto Novaes; Moncau, José Eduardo Cajado; Marcopito, Luiz Francisco [UNIFESP]; Marques, Heloisa Helena de Sousa; Succi, Regina Célia de Menezes [UNIFESP]; Della Negra, Marinella; Hearst, Norman; Secretaria Estadual da Saúde Coordenação Estadual de DST/AIDS de São Paulo; Universidade Federal do Ceará Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Instituto de Infectologia Emílio Ribas; University of CaliforniaAntiretroviral therapy contributes to decreasing morbidity and mortality, and ultimately to increasing survival. In Brazil, there are regional differences in HIV epidemiology regarding pregnant women and children with HIV/AIDS. This study evaluates survival time after AIDS diagnosis in 914 children infected by mother-to-child transmission, reported between 1983 and 1998 and followed until 2002, in Brazil's five regions. Time between birth and HIV diagnosis decreased over the years, mainly in the South and Southeast Regions. There was a significant improvement in survival; more than 75% of cases were still living four years after diagnosis in the 1997-1998 group. This Brazilian study demonstrates that even with regional inequalities in health care infrastructure it is possible for a developing country to establish an effective system of universal and free access to antiretroviral therapy that produces a significant increase in survival for children with AIDS.
- ItemAcesso aberto (Open Access)Mother-to-child transmission of HIV in Brazil during the years 2000 and 2001: results of a multi-centric study(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2007-01-01) Succi, Regina Célia de Menezes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Sociedade Brasileira de Pediatria Departamento de InfectologiaThe objective of this study was to assess mother-to-child transmission rates of HIV in Brazil during the years 2000 and 2001, and to identify the maternal and neonatal variables that were associated with this transmission. It was a cross-sectional, observational study with retrospective data obtained from patient medical records. The children were followed at 63 medical sites situated in five geographical macro-regions of the country (20 States and the Federal Capital). Children enrolled were those that were born of HIV-infected mothers and it was necessary for the mothers to present documented proof of HIV-infection before or during pregnancy, at time of delivery or in the first three months after delivery. There were 2,924 children enrolled and mother-to-child transmission rates of HIV were 8.6% (95%CI: 7.2-10.2) for the year 2000 and 7.1% (95%CI: 5.8-8.6) for the year 2001. The following variables were associated with lower mother-to-child transmission rates of HIV: elective cesarean section, diagnosis of mother's infection before or during pregnancy, access to HIV viral load and T CD4+ lymphocyte count during prenatal care, greater birth weight and avoidance of breastfeeding.