2026, Number 1
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Enf Infec Microbiol 2026; 46 (1)
Care of pregnant women with hiv in an outpatient medical center. from 2008 to 2022
Torruco-García U, Abarca-de Santos D, García-Solano SI, Pérez-de la Rosa AI
Language: Spanish
References: 55
Page: 28-35
PDF size: 162.77 Kb.
ABSTRACT
Background. Reducing perinatal hiv transmission is a sustainable development goal of the World Health Organization
(who). In Mexico, most cases are diagnosed after the first year of life. Most research studies are conducted in
hospital settings; therefore, the objective of this study is to describe the clinical characteristics of pregnant women
with hiv and their newborns who received care at an outpatient center in Xalapa, Veracruz, Mexico, from 2008 to
2022.
Materials and methods. Non-concurrent cohort study. Data were included from pregnant women with hiv who
received care at the outpatient center for the prevention and treatment of aids and sexually transmitted infections
in Xalapa.
Results. 89 pregnancies in 86 women were included in the analysis. Among women diagnosed with hiv before
pregnancy, 33 of 37 were already receiving antiretroviral therapy; 18 of them had a viral load below 200 copies/ml.
Eighty-six pregnancies resulted in cesarean section; all women received antiretroviral treatment. Seven pregnant
women experienced obstetric complications, none of which were fatal. The perinatal transmission rate was 4.7%
if cases lost to follow-up were considered as cases of vertical transmission. If these cases were excluded from the
analysis, the perinatal transmission rate would be zero per cent.
Conclusions. The perinatal transmission rate was very low during the study period.
REFERENCES
United Nations Programme on hiv and aids, “Un ambiciosoobjetivo de tratamiento para contribuir al fin de laepidemia de sida”, UnaidsOrg, 2019, 53: 31-42.
unaids hiv and aids Estimates, “Country fact sheet-Mexico|unaids (2021)”, 2022. Disponible en: https://www.unaids.org/en/regionscountries/countries/mexico.
Organización Panamericana de la Salud, “Elimination ofmother-to-child transmission of hiv and syphilis in theAmericas”, actualizado en 2016, Washington, PAHO2017. Disponible en: https://iris.paho.org/bitstream/handle/10665.2/34072/9789275119556-eng.pdf.
World Health Organization, “Global health sector strategieson, respectively, hiv, viral hepatitis, and sexuallytransmitted infections for the period 2022-2030”.Disponible en: https://www.who.int/publications/i/item/9789240053779.
Organización Panamericana de la Salud, “Developedbased on spectrum hiv estimates 2022 and unaids/who. Global aids monitoring country responses”, 2022.Disponible en: https://www.paho.org/en/file/118812/download?token=MhZ9iNig.
unaids Data 2022. Disponible en: https://unaids.org/sites/default/files/media_asset/data-book-2022_en.pdf.
Mata Marín, J.A., Rivera Mahey, M.G., Chaparro Sánchez,A., Arroyo Anduiza, C.I., Uribe Noguez, C.I.,Berrospe Silva, M.A. et al., “Maternal and neonatalrisk factors associated with increased mother-to-childtransmission of hiv-1 in Mexico: results of a case-controlstudy”, Int j std aids, 2022, 33: 1111-1118.
Irshad, U., Mahdy, H. y Tonismae, T., “hiv in pregnancy”,StatPearls, Treasure Island (FL), StatPearls Publishing,2023. Actualizado el 29 de julio de 2023. Disponible en:https://www.ncbi.nlm.nih.gov/books/NBK558972/.
Centers for Disease Control and Prevention (cdc), “hivMedicine Association of the Infectious Diseases Societyof America; Pediatric Infectious Diseases Society;hhs Panel on Treatment of hiv during pregnancy andprevention of perinatal transmission: a working groupof the Office of aids Research Advisory Council (oarac).Recommendations for the use of antiretroviral drugsduring pregnancy and interventions to reduce perinatalhiv transmission in the United States”, ClinicalInfo.hiv.gov, Rockville (MD), US Department of Health andHuman Services, 2002. Actualizado el 31 de enero de2023. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK586310/.
Hernanz-Lobo, A., Ruiz Sáez, B., Carrasco García, I.,Mino-León, G., Juárez, J., Pavía Ruz, N. et al., “Newdiagnosis of mother-to-child transmission of hiv in 8Latin-American countries during 2018”, bmc Infect Dis,2022, 22: 347.
who, “Number of pregnant women living with hiv thatreceived antiretrovirals in Latin America and the Caribbeanin 2021, by country”, Statista. Recuperado el 23de septiembre de 2023. Disponible en: https://www.statista.com/statistics/1324296/number-pregnant-women-living-hiv-antiretrovirals-latin-america/.
Vrazo, A.C., Golin, R., Fernando, N.B., Killam, W.P., Sharifi,S., Phelps, B.R. et al., “Adapting hiv services for pregnantand breastfeeding women, infants, children, adolescentsand families in resource-constrained settings during thecovid-19 pandemic”, J Int aids Soc, 2020, 23: e25622.
Díaz, A., González, M., Domínguez, A. y Arias, A., “Factoresde riesgo asociados a la transmisión madre-hijodel vih en los pacientes del Capacits de Veracruz”, PerinatolReprod Hum, 2013, 27: 229-234.spss Inc, Released 2009, pasw Statistics for Windows,
Version 18.0, Chicago, spss Inc.Elgalib, A., Al-Hinai, F., Al-Abri, J., Shah, S., Al-Habsi, Z.,
Al-Fouri, M. et al., “Elimination of mother-to-child transmissionof hiv in Oman: a success story from the middleeast”, Eastern Mediterranean Health Journal, 2021, 27:381-389.
Olana, T., Bacha, T., Worku, W. y Tadesse, B.T., “Earlyinfant diagnosis of hiv infection using dna-pcr at a referralcenter: an 8 years retrospective analysis”, aids Res Ther,2016, 13: 29.
Astawesegn, F.H., Stulz, V., Conroy, E. y Mannan, H.,“Trends and effects of antiretroviral therapy coverageduring pregnancy on mother-to-child transmission of hivin Sub-Saharan Africa. Evidence from panel data analysis”,bmc Infect Dis, 2022, 2: 134.
Tukei, V.J., Machekano, R., Gill, M.M., Tiam, A., Mokone,M., Isavwa, A. et al., “24-month hiv-free survival amonghiv-exposed infants in Lesotho: the peawil cohort study”,J Int aids Soc, 2020, 23: e25648.
Hernanz-Lobo, A., Ruiz Sáez, B., Carrasco García, I.,Mino-León, G., Juárez, J., Pavía Ruz, N. et al., “Newdiagnosis of mother-to-child transmission of hiv in 8Latin-American countries during 2018”, bmc Infect Dis, 2022, 22: 347.
Rely, K., Bertozzi, S.M., Ávila-Figueroa, C. y Guijarro,M.T., “Cost-effectiveness of strategies to reduce mother-to-child hiv transmission in Mexico, a low-prevalencesetting”, Health Policy Plan, 2003, 18: 290-298.
Viani, R.M., Ruiz-Calderón, J., López, G., Chacón-Cruz,E. y Spector, S.A., “Mother-to-child hiv transmission in acohort of pregnant women diagnosed by rapid hiv testingat Tijuana general hospital, Baja California, Mexico”,J Int Assoc Physicians aids Care, 2010, 9: 82-86.
Townsend, C.L., Cortina-Borja, M., Peckham, C.S., DeRuiter, A., Lyall, H. y Tookey, P.A., “Low rates of motherto-child transmission of hiv following effective pregnancyinterventions in the United Kingdom and Ireland,2000-2006”, aids, 2008, 22: 973-981.
Koay, W.L.A., Zhang, J., Manepalli, K.V., Griffith, C.J.,Castel, A.D., Scott, R.K. et al., “Prevention of perinatalhiv transmission in an area of high hiv prevalence in theUnited States”, J Pediatr, 2021, 228 :101-109.
Anderson, E.A., Momplaisir, F.M., Corson, C. y Brady,K.A., “Assessing the impact of perinatal hiv case managementon outcomes along the hiv care continuum forpregnant and postpartum women living with hiv, Philadelphia2005-2013”, aids Behav, 2017, 21: 2670-2681.
Katz, I.T., Leister, E., Kacanek, D., Hughes, M.D., Bardeguez,A., Livingston, E. et al., “Factors associated withlack of viral suppression at delivery among highly activeantiretroviral therapy-naive women with hiv a cohortstudy”, Ann Intern Med, 2015, 162: 90-99.
Da Silva Calvo, K., Knauth, D.R., Hentges, B., Leal, A.F.,Da Silva, M.A., Silva, D.L. et al., ·Factors associated withloss to follow up among hiv-exposed children: a historicalcohort study from 2000 to 2017, in Porto Alegre,Brazil”, BMC Public Health, 2022, 22: 1422.
Arango, C., Villegas, D.I., Burbano, L.D. y Quevedo, A.,“Follow up experience of hiv perinatal exposure andaccomplishment of strategies that reduce risk of viraltransmission. Experience of a reference hospital in Medellín”,Biomedica, 2019, 39: 66-77.
Byrne, L., Sconza, R., Foster, C., Tookey, P.A., Cortina-Borja, M. y Thorne, C., “Pregnancy incidence andoutcomes in women with perinatal hiv infection”, aids,2017, 31: 1745-1754.
Piñeirúa, A., Olvera, M., Ponce, M., De la Rosa, J.A.,González, G. y Morales, A., Boletín de atención integralde personas con vih, vol. 5, 2019.
Nesheim, S.R., Fitz Harris, L.F., Gray, K.M y Lampe,M.A., “Epidemiology of perinatal hiv transmission in theUnited States in the era of its elimination”, Pediatric InfectiousDisease Journal, 2019, 38: 611-616.
Nhampossa, T., González, R., Nhacolo, A., Garcia-Otero,L., Quintó, L., Mazuze, M. et al., “Burden, clinicalpresentation and risk factors of advanced hiv diseasein pregnant Mozambican women”, bmc Pregnancy Childbirth,2022, 22: 756.
Fowler, M.G., Qin, M., Fiscus, S.A., Currier, J.S., Flynn,P.M., Chipato, T. et al., “Benefits and risks of antiretroviraltherapy for perinatal hiv prevention”, New EnglandJournal of Medicine, 2016, 375: 1726-1737.
Loyola, F., Ramírez, A. y Varas, A., “El embarazo y losefectos que produce en la salud de las mujeres vih positivas”,Rev Chil Obstet Ginecol, 2022, 86: 554-562.
Prieto, L.M., González-Tomé, M.I., Muñoz, E., Fernández-Ibieta, M., Soto, B., Del Rosal, T. et al., “Low ratesof mother-to-child transmission of hiv-1 and risk factorsfor infection in Spain: 2000-2007”, Pediatr Infect Dis J,2012, 31: 1053-1058.
Lytvyn, L., Siemieniuk, R.A., Dilmitis, S., Ion, A., Chang,Y., Bala, M.M. et al., “Values and preferences of womenliving with hiv who are pregnant, postpartum or consideringpregnancy on choice of antiretroviral therapy duringpregnancy”, bmj Open, 2017, 7: e019023.
Andrews, M.M., Storm, D.S., Burr, C.K., Aaron, E.,Hoyt, M.J., Statton, A. y Weber, S., “Perinatal hiv servicecoordination: closing gaps in the hiv care continuum forpregnant women and eliminating perinatal hiv transmissionin the United States”, Public Health Rep, 2018, 133:532-542.
Favarato, G., Bailey, H., Burns, F., Prieto, L., Soriano-Arandes,A. y Thorne, C., “Migrant women living with hiv inEurope: are they facing inequalities in the preventionof mother-to-child-transmission of hiv?”, Eur J PublicHealth, 2018, 28: 55-60.
Arab, K., Spence, A.R., Czuzoj-Shulman, N. y Abenhaim,H.A., “Pregnancy outcomes in hiv-positive women: a retrospectivecohort study”, Arch Gynecol Obstet, 2017,295: 599-606.
Venkatesh, K.K., Morrison, L., Livingston, E.G., Stek,A., Read, J.S., Shapiro, D.E. et al., “Changing patternsand factors associated with mode of delivery amongpregnant women with human immunodeficiency virusinfection in the United States”, Obstetrics and Gynecology,2018, 131: 879-890.
Günthard, H.F., Saag, M.S., Benson, C.A. et al., “Antiretroviraldrugs for treatment and prevention of hiv infectionin adults: 2016 recommendations of the InternationalAntiviral Society-USA Panel”, jama, 2016, 316: 191-210.Kennedy, C.E., Yeh, P.T., Pandey, S., Betran, A.P. y Narasimhan,
M., “Elective cesarean section for women livingwith hiv: a systematic review of risks and benefits”, aids,2017, 31: 1579-1591.
Tusubira, A.K., Kibira, S.P.S. y Makumbi, F.E., “Moderncontraceptive use among postpartum women livingwith hiv attending mother baby care points in KabaroleDistrict, Uganda”, bmc Womens Health, 2020, 20: 78.
McTigue, G., Swartz, A., Brittain, K., Rini, Z., Colvin, C.J.,Harrison, A. et al., “Contraceptive trajectories postpartum:a longitudinal qualitative study of women livingwith hiv in Cape Town, South Africa”, Soc Sci Med, 2022,292: 114555.
Adeniyi, O.V., Ajayi, A.I., Somefun, O.D. y Lambert, J.S.,“Provision of immediate postpartum contraception towomen living with hiv in the Eastern Cape, South Africa; across-sectional analysis”, Reprod Health, 2020, 17: 194.
Kim, A.J., Barberio, A., Berens, P., Chen, H.Y., Gants, S.,Swilinski, L. et al., “The trend, feasibility, and safety ofsalpingectomy as a form of permanent sterilization”, JMinim Invasive Gynecol, 2019, 26: 1363-1368.
Ludemir, A. y Machado, K., “Canadian ContraceptionConsensus Chapter 6 Permanent Contraception”, Journalof Obstetrics and Gynaecology Canada, 2015, 37: S25-39.
Joan Ibeziako, O., “Natural family planning, an optionin reproductive healthcare: a qualitative study on clinicians’perceptions”, Linacre Q, 2022, 89: 298-318.
Verkuyl, D.A.A., “figo’s ethical recommendations onfemale sterilization will do more harm than good: acommentary”, J Med Ethics, 2015, 41: 478-487.
inegi, Características de los nacimientos registrados enMéxico durante 2020”, Comunicado de prensa, 2021,535: 1-2.
Silverman, M.E., Sami, T.J., Kangwa, T.S., Burgos, L.y Stern, T.A., “Socioeconomic disparity in birth ratesduring the covid-19 pandemic in New York City”, J WomensHealth, 2022, 31: 1113-1119.
McLaren, R.A., Trejo, F.E., Blitz, M.J., Bianco, A., Limaye,M., Brustman, L. et al., “covid-related ‘lockdowns’ andbirth rates in New York”, Am J Obstet Gynecol mfm,2021, 3: 100476.
Nalubega, S., Kyenkya, J., Bagaya, I., Nabukenya, S.,Ssewankambo, N., Nakanjako, D. et al., “covid-19 mayexacerbate the clinical, structural, and psychologicalbarriers to retention in care among women living withhiv in rural and peri-urban settings in Uganda”, bmc InfectDis, 2021, 21: 980.
Bernard, C., Hassan, S.A., Humphrey, J., Thorne, J.,Maina, M., Jakait, B. et al., “Impacts of the covid-19pandemic on access to hiv and reproductive health careamong women living with hiv (wlhiv) in Western Kenya:a mixed methods analysis”, Front Glob Womens Health,2022, 3: 943641.
Solikhah, F.K., “Cases of hiv testing among pregnant womenattending antenatal care during covid-19 pandemic:analysis of data surveillance”, hiv and aids Review, 2022,21: 31-36.
Villafuerte García, A., Magis Rodríguez, C., “El impactode la covid-19 en la detección del vih: a propósito del DíaMundial del sida 2021”, Boletín sobre covid-19, 2021, 2:5-11.