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Multicenter Study
. 2022 Apr 7;22(1):347.
doi: 10.1186/s12879-022-07311-8.

New diagnosis of mother-to-child transmission of HIV in 8 Latin-American countries during 2018

Alicia Hernanz-Lobo  1   2   3 , Beatriz Ruiz Saez #  4 , Itziar Carrasco García #  5   6 , Greta Mino-Leon  7   8 , Julio Juárez  8   9 , Noris Pavía Ruz  8   10 , Dora Estripeaut  8   11   12 , María de Los Ángeles Pérez  8   13 , Karen Erazo  8   14 , Luis Guillermo Castaneda Villatoro  8   15 , Oscar Porras  8   16 , Luis Manuel Prieto Tato  8   17 , María Luisa Navarro Gómez  5   6   8   18   19 ; CYTED PLANTAIDS group
Affiliations
Multicenter Study

New diagnosis of mother-to-child transmission of HIV in 8 Latin-American countries during 2018

Alicia Hernanz-Lobo et al. BMC Infect Dis. .

Abstract

Background: Important prevention efforts have led to a reduction in mother-to-child transmission of HIV (MTCT) globally. However, new cases of paediatric HIV infections still occur. Early diagnosis of new HIV infections is essential to start an appropriate antiretroviral treatment to avoid childhood morbidity and mortality related to infection. The aim of this study was to describe the new cases of MTCT in Latin-American referral hospitals.

Methods: A retrospective, multicentre and descriptive study of the new cases of MTCT diagnosed during 2018 in 13 referral hospitals from 8 Latin-American countries (Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama) belonging to PLANTAIDS (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children), was conducted. PLANTAIDS is included in CYTED (Ibero-American Programme of Science and Technology for Development).

Results: Eighty-one children (40.7% males) were included, median age at diagnosis of 2.33 years (IQR:0.7-4.7). Less than 3% of women knew their HIV diagnosis before pregnancy. More than 80% of them were diagnosed after delivery, 8.7% during pregnancy, and 2.9% at delivery. Only one patient underwent antiretroviral therapy (ART) prior to pregnancy. At diagnosis, 50.0% of the children presented with an advanced stage of disease (stage C following the current CDC classification for HIV infection), and 34.4% had less than 15% CD4+ cells/mm3. The time elapsed between delivery and the maternal diagnosis was correlated with the age of children at diagnosis, ρ = 0.760, p < 0.001. Younger age at diagnosis (p = 0.03), a smaller number of previous hospitalizations (p < 0.01), and better immunovirological status (p < 0.01) were found in children whose mothers knew their HIV status at delivery, compared to mothers who were not aware of it.

Conclusions: Although MTCT in Latin America has declined in recent years, our series shows there are still cases that indicate some failures in prevention, being a critical point to improve an earlier diagnosis of pregnant women. Half of the children were diagnosed in an advanced stage of disease and the delay in maternal diagnosis entailed a worse clinical and immunological child' prognosis.

Keywords: HIV; Infectious disease transmission, vertical; Pregnant women.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
MTCT patients diagnosed in 2018; PLANTAIDS: Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children. MTCT: mother-to-child-transmission of HIV (human immunodeficiency virus). [2] Source: UNAIDS 2018 estimates
Fig. 2
Fig. 2
Correlation between the time of maternal diagnosis and child diagnosis. CDC Centers for Diseases Control and Prevention, HIV human immunodeficiency virus
See this image and copyright information in PMC

References

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