title: [Prevention of vertical HIV-1 transmission in a tertiary care public hospital in Buenos Aires, Argentina].
abstract: OBJECTIVE
  To describe characteristics of mother-child binomium (MCB), antiretroviral (ARV) prophylaxis, time trends, and variables associated with vertical transmission of HIV-1 in a population assisted by a tertiary public hospital in Argentina.
  
  
  METHODS
  Prospective descriptive study undertaken by the Hospital Cosme Argerich s Vertical Transmission Working Group, Buenos Aires city, Argentina 1998-2008. Periods 1998-2003 vs. 2004-2008 were compared and variables associated with vertical transmission identified.
  
  
  RESULTS
  Of 357 MCB, 21.0% of the mothers had HCV coinfection and 68.0% CD4 < 500/µL. During pregnancy, 75.0% received ARV: zidovudine (17.8%), zidovudinelamivudine (19.8%), zidovudine-lamivudine-nevirapine (41.9%), and zidovudinelamivudine-protease inhibitor (11.4%); 74.0% had viral load (VL) peripartum < 1 000 copies/mL. Caesarean delivery: 58.0%. Intrapartum zidovudine: 83.4%; 98.0% of infants received prophylaxis; zidovudine monotherapy was the most frequently used (73.0%). Of neonates, 15.4% had low birthweight and 6.7% were premature. The global vertical transmission was 3.3% (10/302). Comparing both periods, an increase in triple ARV and VL < 1 000 copies/mL in peripartum and a decrease in the absence of maternal/neonatal prophylaxis and overall VT was observed. The vertical transmission for 2004-2008 was 1.3% vs. 6.3% in Buenos Aires city (official statistics). Absence of maternal/intrapartum prophylaxis and prematurity were associated with vertical transmission (P < 0.01 and P = 0.01, respectively).
  
  
  CONCLUSIONS
  A decline in overall vertical transmission between the two periods was observed attributable to increased coverage of maternal/neonatal ARV administration and increased use of triple therapy. The absence of maternal/intrapartum prophylaxis was the main factor associated with vertical transmission, emphasizing the need to improve accessibility of MCB to the local public health system.
authors: Grupo de Trabajo en Prevención de la Transmisión Vertical del VIH-1, Hospital General de Agudos Dr Cosme Argerich, Buenos Aires, Argentina. diegocec@gmail.com
authors: Diego
authors: D
authors: Cecchini
authors: Marina
authors: M
authors: Martinez
authors: Viviana
authors: V
authors: Astarita
authors: Claudia
authors: C
authors: Nieto
authors: Rafael
authors: R
authors: Giesolauro
authors: Claudia
authors: C
authors: Rodriguez
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001118:Argentina; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D015497:HIV-1; D006779:Hospitals, Public; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011446:Prospective Studies; D014504:Urban Health
chemical_list: D044966:Anti-Retroviral Agents