[Detection of HIV infection in pregnant women by rapid testing: a successful strategy to reduce its vertical transmission].
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.


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.
Quian
Jorge
J
Departamento de Pediatría, Universidad de la República. jorgeq@internet.com.uy
Visconti
Ana
A
Gutiérrez
Stella
S
Galli
Ana
A
Maturo
María
M
Galeano
Virginia
V
Serra
Margarita
M
Lioni
Marta
M
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019259:Lamivudine / Q000008:administration & dosage; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011256:Pregnancy Outcome; D015995:Prevalence; D014583:Uruguay; D015215:Zidovudine / Q000008:administration & dosage
D019380:Anti-HIV Agents; D015483:HIV Antibodies; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine