RESUMO
UNLABELLED: A high percentage of Uruguayan pregnant women are not under medical control. As a consequence, vertically transmission of HIV infection reaches to 50%. The aim of this study was to know the prevalence of HIV infection in pregnant women who did not know their serological status and to decrease mother-to-child transmission. PATIENTS AND METHODS: from January 2002 to January 2004 the HIV rapid test was performed to every pregnant woman that assisted to a public Uruguayan hospital unaware of her condition. The proper prophylactic decisions were adopted according to gestational age. The newborn infants were classified according to CDC criteria. HIV infection prevalence in pregnant women and in their newborn infants was calculated. RESULTS: there were 34,338 obstetric consultations and 4,599 rapid tests were performed. Fifty-nine turned out positive in 58 women, 8 of them knew their serological status previously. The HIV infection prevalence was 1.1% (IC95% 0.8-1.4). Five cases were discharged: 1 false positive and 3 miscarriages and 1 abortion. Ten women dropped out in the follow up. Twelve women received TARV during pregnancy for over a week. Thirty-nine infants could be controlled: 33 seroreverted, 4 were exposed and 2 became infected. Mother-to-child transmission was 5.1%. If all patients who dropped out the follow up were infected, the transmission rate should be of 20.4%; therefore the infection would have been prevented in 16 children. As many women and children were lost, other complementary actions as counseling and social worker interview should be adopted in order to improve the yield of rapid test screening strategy.
Assuntos
Fármacos Anti-HIV/administração & dosagem , Anticorpos Anti-HIV/sangue , Infecções por HIV/diagnóstico , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/diagnóstico , Adolescente , Adulto , Western Blotting , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Humanos , Recém-Nascido , Lamivudina/administração & dosagem , Pessoa de Meia-Idade , Nevirapina/administração & dosagem , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Resultado da Gravidez , Prevalência , Uruguai , Zidovudina/administração & dosagemRESUMO
Siguiendo las propuestas de la O.M.S., se han aplicado 151 dosis de vacunas a 28 niños, de los cuales, 17 tienen el cronograma completo para su edad, 4 de ellos tienen SIDA. Se ha registrado una adenitis por BCG en evolución, no observándose otros efectos secundarios. Un niño, a los 7 meses de edad tuvo sarampión. No hubo fracasos de vacunas. Se ha podido correlacionar, inicio de sintomatología de SIDA y vacunas en 4 pacientes. El vacunatorio funciona con las medidas de bioseguridad que corresponden
Assuntos
Lactente , Criança , Humanos , Imunização , Síndrome da Imunodeficiência Adquirida/complicações , VacinasRESUMO
Se analiza la experiencia con el seguimiento de 28 niños VIH positivos y las complicaciones respiratorias. De esos 28 pacientes, 7 de ellos presentaron 15 internaciones por patología respiratoria. En la serie hubo 2 muertos y ambos por insuficiencia respiratoria. Se analizan las historias de los 2 fallecidos. En uno se pudo aislar de la vía respiratoria Neumocistis Carinii y Candida Albicans; en el otro no hubo determinación etiológica pero la historia es similar. El tercer paciente analizado desarrolló una neumonía por seudomona aeruginosa. Se insiste en la importancia de la búsqueda etiológica, en general invasiva en estos niños, que permite tomar actitudes terapéuticas de acuerdo al germen hallado
