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标题：HIV rapid testing as a key strategy for prevention of mother-to-child transmission in Brazil
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作者：Valdiléa G Veloso ; Francisco I Bastos ; Margareth Crisóstomo Portela 等
期刊名称：Revista de Saúde Pública
印刷版ISSN：0034-8910
出版年度：2010
卷号：44
期号：5
页码：803-811
语种：English
出版社：Universidade de São Paulo
摘要：OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant womenat maternity hospital admission and of subsequent interventions to reduceperinatal HIV transmission.METHODS: Study based on a convenience sample of women unaware oftheir HIV serostatus when they were admitted to delivery in public maternityhospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 andApril 2002. Women were counseled and tested using the Determine HIV1/2Rapid Test. HIV infection was confi rmed using the Brazilian algorithm for HIVinfection diagnosis. In utero transmission of HIV was determined using HIVDNA-PCR. There were performed descriptive analyses of sociodemographicdata, number of previous pregnancies and abortions, number of prenatal carevisits, timing of HIV testing, HIV rapid test result, neonatal and mother-tochildtransmission interventions, by city studied.RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegreand 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women weretested during labor (88.7%), while in Rio de Janeiro most were tested in thepostpartum (67.5%). One hundred and forty-four infants were born to 143 HIVinfectedwomen. All newborns but one in each city received at least prophylaxiswith oral zidovudine. It was possible to completely avoid newborn exposureto breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio deJaneiro, respectively. Injectable intravenous zidovudine was administeredduring labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro,respectively. Among those from whom blood samples were collected within48 hours of birth, in utero transmission of HIV was confi rmed in 4 cases inRio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79).CONCLUSIONS: The strategy proved feasible in maternity hospitals in Riode Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testingduring labor. There is a need of strong social support to provide this populationaccess to health care services after hospital discharge.
其他摘要：OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant womenat maternity hospital admission and of subsequent interventions to reduceperinatal HIV transmission.METHODS: Study based on a convenience sample of women unaware oftheir HIV serostatus when they were admitted to delivery in public maternityhospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 andApril 2002. Women were counseled and tested using the Determine HIV1/2Rapid Test. HIV infection was confi rmed using the Brazilian algorithm for HIVinfection diagnosis. In utero transmission of HIV was determined using HIVDNA-PCR. There were performed descriptive analyses of sociodemographicdata, number of previous pregnancies and abortions, number of prenatal carevisits, timing of HIV testing, HIV rapid test result, neonatal and mother-tochildtransmission interventions, by city studied.RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegreand 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women weretested during labor (88.7%), while in Rio de Janeiro most were tested in thepostpartum (67.5%). One hundred and forty-four infants were born to 143 HIVinfectedwomen. All newborns but one in each city received at least prophylaxiswith oral zidovudine. It was possible to completely avoid newborn exposureto breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio deJaneiro, respectively. Injectable intravenous zidovudine was administeredduring labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro,respectively. Among those from whom blood samples were collected within48 hours of birth, in utero transmission of HIV was confi rmed in 4 cases inRio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79).CONCLUSIONS: The strategy proved feasible in maternity hospitals in Riode Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testingduring labor. There is a need of strong social support to provide this populationaccess to health care services after hospital discharge.
关键词：Pregnant Women; Prenatal Care; Breast Feeding; AIDS Serodiagnosis; HIV Infections; diagnosis; Infectious DiseaseTransmission; Vertical; Acquired Immunodeficiency Syndrome; prevention & control.
其他关键词：Pregnant Women; Prenatal Care; Breast Feeding; AIDS Serodiagnosis; HIV Infections; diagnosis; Infectious DiseaseTransmission; Vertical; Acquired Immunodeficiency Syndrome; prevention & control.