Comparativo de la eficacia de la terapia profiláctica antiretroviral para la reducción del riesgo de transmisión materno infantil vih, Hospital Gineco Obstétrico Enrique C. Sotomayor de 1 de enero del 2007 al 31 de diciembre del 2012
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2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: En ausencia de cualquier intervención, algunos estudios reportan que las tasas de transmisión son de un 15% - 45%, dependiendo del lugar de estudio y de si las madres infectadas por VIH, amamantaban o no a sus hijos. Intervenciones eficaces permiten reducir esas cifras a niveles inferiores al 2%.(ENS) Método: Se evaluó comparativamente la transmisión del Virus de Inmunodeficiencia Adquirida (VIH) de una madre seropositiva a su hijo, para lo cual se clasificaron a las gestantes con infección por VIH en 3 grupos de acuerdo al momento de inicio de esquema antirretroviral (1: desde las 14 semanas de gestación embarazo; 2: previo al parto por Cesárea; 3: NO recibió ARV ni durante la gestación ni previo al parto vaginal). Este trabajo se realizó en el Hospital Gineco Obstètrico “Enrique C Sotomayor desde el 1 de Enero 2007 al 31 de Diciembre del 2012. Resultados: En este periodo se realizaron 218.742 Pruebas Rápidas VIH, de las cuales se reportaron 1.095 resultados Reactivos, se confirmaròn 1.063 gestantes con infecciòn VIH, por lo que 32 resultados fueron considerados Falsos + VIH, (2.92%); cumplieron con los criterios de inclusión del estudio 594 Gestantes infectadas por VIH (56%). De las 594 gestantes infectadas por VIH el 95% (n=567) tuvo su parto por Cesárea y el 5% (n= 27) tuvo parto vaginal. Del total de niños expuestos perinatales n= 607, se han excluido a los neonatos que fallecieron (n=18) por cuanto se desconoció en ellos los resultados de la carga viral VIH, por lo que el total de expuestos perinatales vivos es de n= 589. Grupo 1: Gestantes con Infección por VIH que recibieron TARP durante el embarazo y previo al parto por Cesárea n= 287, NO se reportan niños infectados al VIH, siendo para este grupo la tasa de TTMI-1 de 0%. Grupo 2: Gestantes con Infección por VIH que NO recibieron TARP durante el embarazo pero si se administró TARP previo al parto por Cesárea n= 275, se reportaron n=14 niños infectados VIH, siendo para este grupo la tasa de TMMI-2, de 5.1 %. Grupo 3: Gestantes con Infección por VIH, que NO recibieron TARP durante el embarazo ni previo al parto por Vaginal n= 27, se reportaron n=5 niños infectados al VIH, siendo para este grupo la tasa de TTMI-3: 18,5%. Conclusión: La detección oportuna e inicio temprano de ARV a partir del I trimestre del embarazo previene la TMI VIH (NNT) y mejorar la calidad y pronostico de vida de las gestantes infectada por VIH y sus hijos
Background: In the absence of any intervention, some studies report that transmission rates are 15% - 45%, depending on the place of study and whether HIV-infected mothers breastfed their children or not. Effective interventions allow these figures to be reduced to levels below 2%. (ENS) Method: The transmission of Acquired Immunodeficiency Virus (HIV) from an HIV-positive mother to her child was evaluated comparatively, for which pregnant women were classified as infected by HIV in 3 groups according to the time of initiation of antiretroviral scheme (1: from 14 weeks of pregnancy pregnancy; 2: prior to delivery by Caesarean section; 3: NOT received ARV either during pregnancy or prior to vaginal delivery). This work was carried out at the "Enrique C Sotomayor Obstetric Gynecological Hospital from January 1, 2007 to December 31, 2012. Results: During this period 218,742 Rapid HIV Tests were performed, of which 1,095 Reactive results were reported, 1,063 were confirmed pregnant women with HIV infection, so 32 results were considered False + HIV, (2.92%); 594 HIV-infected pregnant women (56%) met the inclusion criteria of the study. Of the 594 HIV-infected pregnant women, 95% (n = 567) had a Cesarean delivery and 5% (n = 27) had a vaginal delivery. Of the total number of children exposed perinatal n = 607, infants who died (n = 18) have been excluded because the results of HIV viral load were unknown in them, so the total number of live perinatal exposures is n = 589. Group 1: Pregnant women with HIV infection who received TARP during pregnancy and before delivery by Caesarean section n = 287, children infected with HIV are NOT reported, being for this group the TTMI-1 rate of 0%. Group 2: Pregnant women with HIV infection who did NOT receive TARP during pregnancy but if TARP was given prior to delivery by Caesarean section n = 275, n = 14 HIV infected children were reported, being for this group the rate of TMMI-2, of 5.1% Group 3: Pregnant women with HIV infection, who did NOT receive TARP during pregnancy or before birth by Vaginal n = 27, n = 5 children infected with HIV were reported, being for this group the rate of TTMI-3: 18.5 %. Conclusion: Timely detection and early onset of ARV from the first trimester of pregnancy prevents HIV IMT (NNT) and improve the quality and prognosis of life of pregnant women infected with HIV and their children
Background: In the absence of any intervention, some studies report that transmission rates are 15% - 45%, depending on the place of study and whether HIV-infected mothers breastfed their children or not. Effective interventions allow these figures to be reduced to levels below 2%. (ENS) Method: The transmission of Acquired Immunodeficiency Virus (HIV) from an HIV-positive mother to her child was evaluated comparatively, for which pregnant women were classified as infected by HIV in 3 groups according to the time of initiation of antiretroviral scheme (1: from 14 weeks of pregnancy pregnancy; 2: prior to delivery by Caesarean section; 3: NOT received ARV either during pregnancy or prior to vaginal delivery). This work was carried out at the "Enrique C Sotomayor Obstetric Gynecological Hospital from January 1, 2007 to December 31, 2012. Results: During this period 218,742 Rapid HIV Tests were performed, of which 1,095 Reactive results were reported, 1,063 were confirmed pregnant women with HIV infection, so 32 results were considered False + HIV, (2.92%); 594 HIV-infected pregnant women (56%) met the inclusion criteria of the study. Of the 594 HIV-infected pregnant women, 95% (n = 567) had a Cesarean delivery and 5% (n = 27) had a vaginal delivery. Of the total number of children exposed perinatal n = 607, infants who died (n = 18) have been excluded because the results of HIV viral load were unknown in them, so the total number of live perinatal exposures is n = 589. Group 1: Pregnant women with HIV infection who received TARP during pregnancy and before delivery by Caesarean section n = 287, children infected with HIV are NOT reported, being for this group the TTMI-1 rate of 0%. Group 2: Pregnant women with HIV infection who did NOT receive TARP during pregnancy but if TARP was given prior to delivery by Caesarean section n = 275, n = 14 HIV infected children were reported, being for this group the rate of TMMI-2, of 5.1% Group 3: Pregnant women with HIV infection, who did NOT receive TARP during pregnancy or before birth by Vaginal n = 27, n = 5 children infected with HIV were reported, being for this group the rate of TTMI-3: 18.5 %. Conclusion: Timely detection and early onset of ARV from the first trimester of pregnancy prevents HIV IMT (NNT) and improve the quality and prognosis of life of pregnant women infected with HIV and their children
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Virus de inmunodeficiencia humana, Antirretrovirales, Transmisión maternoinfantil, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador