Trends in maternal-infant transmission of AIDS after antiretroviral therapy in Brazil

Abstract

OBJECTIVE: the increase in the number of AIDS cases among women has lead to an increase in the maternal-infant transmission of human acquired immunodeficiency virus. Measures for the control of this type of transmission were implemented in Brazil in 1996. The aim of the present study was to analyze time trends in maternal-infant transmission of AIDS among Brazilian children. METHODS: The present study included children born in Brazil between 1990 and 2001. We used the database of notified AIDS cases in children 13 years of age or younger between 1990 and 2004. Exponential regression models adjusted to the time series provided the annual variation rates and observed and expected values for the period. RESULTS: We found a significant increasing trend for cases born prior to the year in which anti retroviral therapy was introduced, with an increase rate of about 12% (t<0.003) per year. Rates from different states ranged from 5.9% to 31%. The analysis of expected and observed cases for each of the country's five Regions showed a reduction in the number of cases among children born from 1997 onwards, with a progressive year-to-year reduction. The number of notified cases among children born in 2001 was less than 10% the number of expected cases. CONCLUSIONS: The results obtained suggest a favorable response the implementation of policies for the prevention of maternal-infant HIV transmission in Brazil, as observed in other parts of the world.