Publication: Características y evolución de los programas de prevención de la transmisión vertical de VIH en entornos diferentes
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2017-10-06
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Universidad Complutense de Madrid
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Abstract
Se estima que actualmente 35 millones de personas viven con la infección por VIH a nivel mundial. En la última década se han realizado grandes avances en el control de la epidemia, lo que ha permitido un reducción de aproximadamente el 40% de las nuevas infecciones. De igual modo, a escala mundial, se ha observado una reducción de hasta un 58% en las nuevas infecciones en niños en 2013 respecto a 2001. Desde el inicio de la epidemia de la infección por el VIH, la transmisión vertical del virus de una madre infectada a su hijo se ha considerado un problema de salud pública de primera magnitud. La reducción en las tasas de infección en los niños se ha conseguido con la puesta en marcha de programas específicos de prevención de la transmisión vertical de VIH. Estos programas presentan características muy diferentes según el entorno en el que se desarrollan. Así, en los países con recursos limitados, la alta morbimortalidad materna e infantil asociada a la infección por VIH ha llevado progresivamente hacia un enfoque programático en la estrategia de la prevención de la transmisión vertical, y en los países con mayores recursos, los programas han presentado progresivamente un enfoque más individualizado. OBJETIVOS En relación a todo ello, el objetivo general de esta memoria fue estudiar las características y la evolución temporal de los programas de prevención de la transmisión vertical de VIH-1 en dos cohortes de diferentes entornos: una cohorte de mujeres con infección por VIH-1 y sus hijos expuestos en Madrid, España, y una cohorte de mujeres con infección por VIH-1 y sus hijos expuestos en Bata, Guinea Ecuatorial...
At the end of 2013, there were 35 million people living with HIV worldwide. Progress in stopping new HIV infections has been dramatic in last teen years. In 2013, 240 000 children were newly infected with HIV. This is 58% lower than in 2001. Since the beginning of the epidemic, HIV mother-to-child transmission (MTCT) has been recognised as a major public health issue. Great efforts have been done to reduce HIV infection among children. Scaling-up of effective and comprehensive prevention of MTCT services is the key for the success achieved. The WHO (World Health Organisation) recommends a programmatic approach to the prevention of vertical transmission. However, in settings where resources are less limited an individualised approach can be adopted. AIM In this context, we aimed to describe temporal patterns in the management of HIV-1 infected women and their newborns and to analyze the changes over time in the MTCT rates and risk factors in a multicenter prospective cohort in Madrid, Spain, but also in a prospective cohort in Bata, Equatorial Guinea. We assessed HIV-1 MTCT rates and risks factors for infection in the Madrid Cohort of HIV-1 infected mothers and infants from 2000 to 2007. We also evaluated from 2000 to 2009 the prevalence of birth defects in children exposed in utero to antiretroviral drugs (ARVs) and assessed the association between in utero exposure to ARVs and birth defects in the Madrid Cohort of HIV-mother and infants pairs...
At the end of 2013, there were 35 million people living with HIV worldwide. Progress in stopping new HIV infections has been dramatic in last teen years. In 2013, 240 000 children were newly infected with HIV. This is 58% lower than in 2001. Since the beginning of the epidemic, HIV mother-to-child transmission (MTCT) has been recognised as a major public health issue. Great efforts have been done to reduce HIV infection among children. Scaling-up of effective and comprehensive prevention of MTCT services is the key for the success achieved. The WHO (World Health Organisation) recommends a programmatic approach to the prevention of vertical transmission. However, in settings where resources are less limited an individualised approach can be adopted. AIM In this context, we aimed to describe temporal patterns in the management of HIV-1 infected women and their newborns and to analyze the changes over time in the MTCT rates and risk factors in a multicenter prospective cohort in Madrid, Spain, but also in a prospective cohort in Bata, Equatorial Guinea. We assessed HIV-1 MTCT rates and risks factors for infection in the Madrid Cohort of HIV-1 infected mothers and infants from 2000 to 2007. We also evaluated from 2000 to 2009 the prevalence of birth defects in children exposed in utero to antiretroviral drugs (ARVs) and assessed the association between in utero exposure to ARVs and birth defects in the Madrid Cohort of HIV-mother and infants pairs...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Pediatría, leída el 18-01-2016