Produção Nacional
Revisado por pares
Estimated Incidence and Genotypes of HIV-1 among Pregnant Women in Central Brazil
2013; Public Library of Science; Volume: 8; Issue: 11 Linguagem: Inglês
10.1371/journal.pone.0079189
ISSN1932-6203
AutoresZelma Bernardes Costa, Mariane Martins de Araújo Stefani, Yanna Andressa Ramos de Lima, Wayner Vieira de Souza, Noêmia Teixeira de Siqueira Filha, Marília Dalva Turchi, Walter Costa Borges, Clidenor Gomes Filho, José Vicente Macedo Filho, Ana Lúcia Minuzzi, Celina Maria Turchi Martelli,
Tópico(s)Sex work and related issues
ResumoObjectiveTo estimate the incidence of HIV-1 infection among pregnant women from central-western Brazil. DesignObservational cross-sectional study. MethodsA total of 54,139 pregnant women received antenatal HIV screening from a network of public healthcare centers in 2011. The incidence of confirmed HIV-1 infection was estimated using the Serological Testing Algorithms for Recent HIV Seroconversion (STARHS) methodology and BED-capture enzyme immunoassay (BED-CEIA). The yearly incidence was calculated, and adjusted incidence rates were estimated. For a subgroup of patients, protease and partial reverse transcriptase regions were retrotranscribed from plasma HIV-1 RNA and sequenced after performing a nested polymerase chain reaction. ResultsOf the participants, 20% had a pregnancy before the age of 18 and approximately 40% were experiencing their first pregnancy. Of the 54,139 pregnant women screened, 86 had a confirmed HIV-1 diagnosis, yielding an overall prevalence of 1.59 cases per 1000 women (95% CI 1.27–1.96). A higher prevalence was detected in the older age groups, reflecting cumulative exposure to the virus over time. Among the infected pregnant women, 20% were considered recently infected according to the BED-CEIA. The estimated incidence of HIV infection was 0.61 per 1000 person-years (95% CI 0.33-0.89); the corrected incidence was 0.47 per 1000 person-years (95% CI 0.26-0.68). In a subgroup of patients, HIV-1 subtype C (16.7%) was the second most prevalent form after subtype B (66.7%); BF1 recombinants (11.1%) and one case of subtype F1 (5.5%) were also detected. ConclusionThis study highlights the potential for deriving incidence estimates from a large antenatal screening program for HIV. The rate of recent HIV-1 infection among women in their early reproductive years is a public health warning to implement preventive measures.
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