[Prevalence of congenital and perinatal infection in HIV positive pregnant in Belo Horizonte metropolitan region].
OBJECTIVE
To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors.


METHODS
A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs.


RESULTS
Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis.


CONCLUSIONS
The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.
Grupo de Pesquisa em HIV/Aids Materno/Infantil, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Marcelle Marie Martins
MM
Maia
Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Eura Martins
EM
Lage
Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Bárbara Cecília Borges
BC
Moreira
Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Elayne Alayne Braga de
EA
Deus
Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Joanna Gonçalves
JG
Faria
Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Jorge Andrade
JA
Pinto
Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.
Victor Hugo
VH
Melo
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000469:parasitology; D006679:HIV Seropositivity; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007239:Infections / Q000151:congenital* / Q000453:epidemiology*; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D015995:Prevalence; D014504:Urban Health