title: High occurrence of HIV-positive siblings due to repeated mother-to-child transmission in Brazil.
abstract: Pregnancies in women without knowledge of their HIV-positive status increase the risk of mother-to-child transmission, and of disease progression. This study aimed to characterize the frequency of multiple pregnancies and of HIV-positive children in the family, during HAART era. We analyzed data of a national multicenter cohort study among Brazilian children with AIDS diagnosed between 1999 and 2002. In total, 945 children and their 928 mothers were included. Five hundred and ninety (64.6%) women had a history of multiple pregnancies, and 49.5% attended prenatal care (mean: 3.5 consultations; SD 3.6). In 483 child cases, HIV status of the sibling was known; 130 (26.9%) of these were infected with HIV. In 38.5% of cases, the child with AIDS included in the cohort study was the first case in the family. Despite the overall positive results of the Brazilian control policy of HIV/AIDS, our study shows that HIV infection in pregnant women was often undetected and that consequently there was a high frequency of repeated HIV-infected children. There is a need to improve comprehensive prenatal and postnatal care of Brazilian women. HIV-affected families are most vulnerable and should be targeted by specific control programs, preventing additional HIV infections in other children.
authors.affiliation: Department of Community Health, Federal University of Ceará, Fortaleza, Brazil. novaes@ufc.br
authors.forename: Alberto N
authors.initials: AN
authors.lastname: Ramos
authors.forename: Luiza H
authors.initials: LH
authors.lastname: Matida
authors.forename: Norman
authors.initials: N
authors.lastname: Hearst
authors.forename: Fabíola Araújo
authors.initials: FA
authors.lastname: Oliveira
authors.forename: Jorg
authors.initials: J
authors.lastname: Heukelbach
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D008297:Male; D008427:Maternal Health Services; D009035:Mothers; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D012189:Retrospective Studies; D035781:Siblings