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Topic: B31 Integrating prevention into treatment and care services

Cross-cutting Theme: 3. Health Systems Strengthening & Integration
Title: Outcome of a program for the prevention of the mother to child HIV infection
in women who knew their HIV status before be pregnant
Author(s): M. Mantilla1, A. Bermúdez1, M.A. Román1, S. Valderrama1, A. Medina2, A. Correa3,
R. Perea4, P. Diruggiero5, C. Alquichire1
Institute(s): 1Grupo SaludCoop Clinica Jorge Piñeros Corpas, Cundinamarca, Bogotá,
Colombia, 2Grupo SaludCoop Clinica regional Córdoba, Córdoba, Monteria,
Colombia, 3Grupo SaludCoop Clinica Regional de Occidente, Valle del Cauca,
Cali, Colombia, 4Grupo SaludCoop Clinica Regional Santander, Santander,
Bucaramanga, Colombia, 5Grupo SaludCoop Clinica Regional Costa Norte,
Atlántico, Barranquilla, Colombia
Text: Background: To know the outcome in preventing mother to child (PMTC) HIV
transmission in women who knew their HIV status before they be pregnant in a
private institution (Grupo SaludCoop) belong to the Social Security in Colombia.
Methods: We reviewed the information in our national database from January 1
2001 to December 31 2005. The criteria for inclusion were: 1. Women who had a
positive HIV Western Blot (WB) before they be pregnant. 2. Received antenatal
  control care in a HIV clinic belong to the Grupo SaludCoop during January 1 2001
 
to December 31 2005. 3.To have from the child of the patient at least the results of
two viral load (VL) measures before 18 months of age or the result of a HIV WB
after 18 months of age.
Results: Twenty six of the 29 pregnant filled the three inclusion criteria. The
median age was 26 years. 62%, had a male partner with HIV infection too. Only 48
% of the women began their antenatal control during the first trimester. 62% of the
women had been taking antiretroviral therapy (ART) before they be pregnant,
nonetheless worrisome, when they assisted to the first antenatal control, 78% had
a detectable VL. In the 97% of the cases, the pregnancy finished after the 37
weeks. Ninety percent of the women underwent programmed cesarean. 100% of
the pregnant women received IV zidovudine and 100% of the new born AZT
suspension according to ACTG 067 protocol during 42 days. All 26 children,
100%, had 2 or more VL undetectable at the first month of life or had a negative
WB after 18 months of life.
Conclusions: Our results show the efficacy of an interdisciplinary HIV program in
a constrain resource country in preventing MTC HIV transmission in women who
knew their HIV status before be pregnant.
Country of research: Colombia

   
  Conference: AIDS 2008 · Abstract: A-072-0092-07248 · Status: Submitted
 Abstract Preview - Step 3/4
This abstract is submitted!  

  Topic: B31 Integrating prevention into treatment and care services  

Cross-
cutting 3. Health Systems Strengthening & Integration
Theme:
Title: Outcome of a program for the prevention of the mother to child HIV infection in women
who knew their HIV status before be pregnant
Author( M. Mantilla1, A. Bermúdez1, M.A. Román1, S. Valderrama1, A. Medina2, A. Correa3, R. Perea4, P.
s): Diruggiero5, C. Alquichire1
Omca70@yahoo.com
Institute 1Grupo SaludCoop Clinica Jorge Piñeros Corpas, Cundinamarca, Bogotá, Colombia, 2Grupo
(s): SaludCoop Clinica regional Córdoba, Córdoba, Monteria, Colombia, 3Grupo SaludCoop Clinica
Regional de Occidente, Valle del Cauca, Cali, Colombia, 4Grupo SaludCoop Clinica Regional
Santander, Santander, Bucaramanga, Colombia, 5Grupo SaludCoop Clinica Regional Costa
Norte, Atlántico, Barranquilla, Colombia
Text: Background: Mother to child HIV transmission (MTCT) can occurs in 20%- 28% of the cases
without antiretroviral therapy (ART) and it falls to 1%- 2% with the use of ART. Currently in the
developed countries remarkable progress has been made toward maximally reduce the mother
to child HIV transmission to levels near to 0% . However in the developing settings where more
than 95% of all cases of MTCT occurs, only a low percentage of HIV women has the opportunity
of access to medical services to prevent MTCT. According to UNAIDS nowdays there are around
the world nearly ….children living with HIV. In the restrain resource countries, as in Colombia,
the majority of the children with HIV have been infected by mother to child transmission. For this
reason set up prevention programs to control this mode of HIV transmission is an important
public health option to control the epidemic in the infant population.
Most women with HIV worldwide are infected during their reproductive years, a time of decision-
making about family planning particularly with the universal access to ART. In the clinical setting
every time is more frequent to find pregnant HIV infected women who knew their HIV status
before pregnancy.

Objectives:
 To know the outcome in preventing mother to child (PMTC) HIV transmission in women
who knew their HIV status before they be pregnant in a private institution (Grupo
SaludCoop) belong to the Social Security in Colombia.
 To know the HIV prevalence among the partners of the HIV pregnant women.
 To establish the frequency of premature delivery and the mode of delivery in this
population.
 To know the opportunity for the first antenatal control in this population.

Methods: We reviewed the information in our national database from January 1 2001 to
December 31 2005. The criteria for inclusion were:
1. Women who had a positive HIV Western Blot (WB) before they be pregnant. 2. Received
antenatal control care in a HIV clinic belong to the Grupo SaludCoop during January 1 2001 to
December 31 2005.
3.To have from the child of the patient at least the results of two viral load (VL) measures before
18 months of age or the result of a HIV WB after 18 months of age.

Results: Twenty nine of the 31 pregnant filled the three inclusion criteria. The median age was
26 years. 62%, had a male partner with HIV infection too, 17% had a HIV negative partner and
21% of them did not know the HIV status of her partner, because he has not (se ha realizado
aun la prueba)
Only 48 % of the women began their antenatal control during the first trimester, 41% in the
second trimester and 11% in the third trimester. 62% of the women had been taking
antiretroviral therapy (ART) before they be pregnant. Nonetheless of interest, when they
attended the first antenatal control, 78% had a detectable VL.
The ART used during their pregnancy was: 2 NRTI + 1 PI in 56% of the cases, and 2 INRT + 1
NNRTI in 26% of the cases. In the 97% of the cases, the pregnancy finished after the 37 weeks.
Ninety percent of the women underwent programmed cesarean, 7% emergency cesarean and
3% vaginal delivery. 100% of the pregnant women received IV zidovudine and 100% of the new
born AZT suspension according to ACTG 067 protocol during 42 days. All 26 children, 100%,
had 2 or more VL undetectable from the first month of life or had a negative WB after 18 months
of life.In our group mother to child transmission rate was 0%.
Conclusions: Our results show the efficacy of an interdisciplinary HIV program in a constrain
 resource country in preventing MTC HIV transmission in women who knew their HIV status
before be pregnant. We recommend that each woman along with her partner should be
assessed formally for the desire to have a baby and counseled properly for the effective use of
family planning methods at every regular clinic visits.
Country
of
Colombia
researc
h: