[Changes in vertical HIV transmission: comparison between 1994 and 2004].
OBJECTIVE
Vertical transmission (VT) is the main route of human immunodeficiency virus (HIV) infection in children. Since the publication of PACTG 076 study in 1994, several preventive methods against the vertical transmission of the HIV have been developed. In this study, we compare the clinical and epidemiological profile of HIV-infected pregnant women and the VT rate in the years 1994 and 2004.


METHODS
We looked at maternal, obstetric and pediatric variables of HIV-infected women and their children, born in 1994 and 2004, who were followed in Hospital La Paz.


RESULTS
We included 40 mother-infant couples in 1994 and 35 couples in 2004. The HIV vertical transmission rate was 35% in 1994 and 0% in 2004. We did not find changes in Hepatitis C virus (HCV) vertical transmission. In 1994, HIV-infected mothers had a more advanced HIV-disease and the major route of HIV-transmission was the intravenous drug use. Vaginal delivery was more frequent and rupture of membranes was longer than in 2004. The main route of maternal HIV infection in 2004 was sexual contact. In this same year, the use of combination antiretroviral therapy, even during pregnancy, was generalized, the elective cesarean section was the most frequent form of delivery, and every newborn received zidovudine.


CONCLUSIONS
In the last decade, there have been important epidemiological changes in HIV-infected mothers in our society. The administration of antiretroviral therapy during pregnancy and to the newborn, as well as other obstetric strategies, can prevent HIV vertical transmission. Nevertheless, we did not find any change in the risk of HCV vertical transmission.
Orío
Mireya
M
Servicio de Enfermedades Infecciosas, Hospital Universitario Infantil La Paz, Madrid, Spain.
Peña
José M
JM
Rives
M Teresa
MT
Sanz
Mario
M
Bates
Isabel
I
Madero
Rosario
R
de José
M Isabel
MI
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000009:adverse effects; D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000151:congenital / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D012725:Sexual Behavior; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine