Fatores associados à transmissão vertical do HIV em pacientes assistidas em um serviço de referência na Paraíba: um estudo caso-controle.

Abstract

Introduction: The human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) epidemic is a global reality and because of its dynamism, heterogeneity and magnitude, this is one of the greatest public health challenges in the world. The vulnerability of children exposed to vertical transmission by their mothers during the gestational, puerperal, and post-puerperal periods shows the need to plan and operationalize strategies that ensure the efficiency of HIV prevention services. Objectives: This investigation is an epidemiologic observational study of control-case type which goal is evaluate associated factors to HIV vertical transmission in Lauro Wanderley University Hospital¿s (LWUH) Specialized Family Assistance Service (SFA). Method: For the sample were considered 27 vertical transmission registered cases from SFA database, with a control group of 108 non-infected children born from HIV positive mothers. They were selected on 4:1 proportion by random sample. To obtain information for this study¿s interest, was used a questionnaire for mother¿s social demographic characterization, from prenatal and child-birth, besides child¿s characterizations from clinic and therapeutic data. This data was collected between 2018¿s January and February, after UNISANTOS Ethics Committee approval. For data analysis, was used descriptive statistics to sample characterization of cases and controls, as bivariate and multiple logistic regression models, considering 5% significance level when associate to vertical HIV transmission (denouement) occurrence. Results and Discussion: Was observed that variables such as antiretroviral usage during prenatal by mother, AZT using time, mother¿s scholarship and AZT¿s usage intrapartum were negatively associated to HIV vertical transmission, in other words, as a protection factor. Was possible to verify that a child, whose mother didn¿t use antiretroviral during prenatal, has approximately 12 times more chances to presenting a HIV viral load through vertical transmission. Other meaningful discovery is that a child whose mother scholarship is up to basic level completed has 11 times more chances to getting the disease. Besides, is possible to observe intrapartum AZT usage is a protection factor, reducing to 26% the child risk of getting HIV through vertical transmission. Final Considerations: The factors associated to VT factors sustain the matter of early identification of pregnant women infected by HIV, since an adequate HIV assistance and diagnosis during prenatal collaborates to obtain lower VT ranks.