title: HIV-1 infection and pregnancy in young women in Brazil: socioeconomic and drug resistance profiles in a cross-sectional study.
abstract: To describe socioeconomic and antiretroviral (ARV) drug resistance profiles among young pregnant women infected with HIV-1.
  
  
  
  A public health antenatal programme responsible for screening ∼90 000 pregnant women per year for nine different infectious diseases in Central Western Brazil.
  
  
  
  96 young pregnant women (15-24 years) infected with HIV-1.
  
  
  
  Standard interviews and blood samples were taken at the time of recruitment, at the first medical appointment after confirmation of diagnosis of HIV-1 infection, and before ARV prophylaxis initiation. Clinical and laboratory data were retrieved from medical files. HIV-1 pol gene sequences (entire protease/PR, partial reverse transcriptase/RT) were obtained from plasma RNA. ARV resistance mutations (CPR/Stanford HIV-1; International AIDS Society-USA databases) were identified.
  
  
  
  The median age was 21 years; most reported <8 years education; 73% were recently diagnosed. Approximately 20% (19/96) presented late for antenatal care (after 26 gestational weeks), while 49% reported ≥2 previous pregnancies. Possible heterosexual transmission by an HIV-1 infected partner (17%) and commercial sex work (2%) were reported. The median of CD4 cell count was 526 cells/mm(3); the median viral load was: 10 056 copies/mL in ARV-naïve (48/96) patients and 5881 copies/mL in ARV-exposed (48/96) patients. Two probable seroconversion cases during pregnancy were identified in adolescents. One mother-to-child transmission case (1.0%) was observed. Transmitted drug resistance among ARV-naïve patients was 9.3% (CI 95% 3.3% to 19.6%); secondary drug resistance among ARV-exposed patients was 12.5% (CI 95% 4.7% to 25.6%).
  
  
  
  Despite high access to antenatal care, the low socioeconomic-educational profiles seen in these young HIV-1-infected women highlight the necessity of improved public health educational and preventive strategies regarding HIV infection and early unplanned pregnancy.
authors.affiliation: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Yanna Andressa Ramos
authors.initials: YA
authors.lastname: Lima
authors.affiliation: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Mônica Nogueira Guarda
authors.initials: MN
authors.lastname: Reis
authors.affiliation: Department of Medicine, Federal University of Goiás, Jataí, Goiás, Brazil.
authors.forename: Ludimila Paula Vaz
authors.initials: LP
authors.lastname: Cardoso
authors.affiliation: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Mariane Martins Araújo
authors.initials: MM
authors.lastname: Stefani
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral / Q000235:genetics / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000635:transmission*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D012307:Risk Factors; D011477:Sex Work; D019562:Viral Load; D035862:Vulnerable Populations; D055815:Young Adult; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000187:drug effects*
chemical_list: D019380:Anti-HIV Agents; D054302:pol Gene Products, Human Immunodeficiency Virus
keywords: Drug resistance; HIV-1; Pregnancy; young women