Vertical Transmission of HIV-1 in the Metropolitan Area of Belo Horizonte, Brazil: 2006-2014.

Objective To revise HIV-1 vertical transmission (VT) rates in the metropolitan area of Belo Horizonte, Brazil, from January of 2006 to December of 2014. Methods Descriptive study of a prospective cohort of HIV-1-infected pregnant women and their children, monitored by the Maternal and Child HIV/Aids Research Group of Research Group at Faculty of Medicine of Universidade Federal de Minas Gerais, Brazil. Results The VT general rate was 1.9% (13/673; confidence interval [CI] 95%: 1.0-3.3). The extensive use of combined highly active antiretroviral therapy (HAART) (89.7%; 583/650) strongly impacted the reduction of VT during this period. Maternal viral load (VL) higher than 1,000 copies/mL showed significant association with VT (OR:6.6; CI 95%:1.3-33.3). Maternal breastfeeding was described in 10 cases in this cohort (1.5%; CI 95%: 0.7-2.7), but it was not associated with VT. Conclusion The present cohort data were coherent with the low VT rate described in other global populations, and it was considerably lower in comparison to the results of the same cohort during the period of 1998-2005, when the VT rate was 6.2%. These data confirm the efficiency of the National Guidelines, and emphasize the importance of adopting the international recommended procedures for prevention of mother-to-child transmission (MTCT) of HIV. Resumo Objetivo Rever as taxas de transmissAo vertical (TV) do HIV-1 na area metropolitana de Belo Horizonte, Brasil, de janeiro de 2006 a dezembro de 2014. Metodos Estudo descritivo de uma coorte prospectiva de gestantes infectadas pelo HIV-1 e seus filhos, monitorados pelo Grupo de Pesquisa em HIV/Aids Materno-Infantil, da Faculdade de Medicina da Universidade Federal de Minas Gerais, Brasil. Resultados A taxa geral de TV foi de 1,9% (13/673; intervalo de confianca [IC] 95%: 1,0-3,3). O uso extensivo de terapia antirretroviral combinada (TARVc) (89,7%; 583/650) impactou fortemente a reducAo de TV durante este periodo. Carga viral materna superior a 1.000 copias/mL mostrou associacAo significante com TV (OR: 6,6; IC 95%:1,3-33,3). A amamentacAo materna foi descrita em 10 casos nesta coorte (1,5%; IC 95%: 0,7-2,7), mas nAo foi associada a TV. ConclusAo Os dados atuais da coorte foram coerentes com a baixa taxa de TV descrita em outras populacoes globais, e foi consideravelmente menor em comparacAo com os resultados da mesma coorte no periodo de 1998-2005, quando a taxa de TV foi de 6,2%. Esses dados confirmam a eficiencia das Diretrizes Nacionais, e enfatizam a importancia de adotar os procedimentos internacionais recomendados para a prevencAo da transmissAo do HIV da mAe para o filho.