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PREVALENCE AND RISK FACTORS FOR HEPATITIS C AND HIV-1 INFECTIONS AMONG PREGNANT WOMEN IN CENTRAL BRAZIL
Mulher grávida
Infecção pelo Vírus da Imunodeficiência Humana
Mulher negra
Resultado Indeterminado
Pregnant Woman
Human Immunodeficiency Virus Infection
Black Woman
Indeterminate Result
Adulto
Idade
Fatores Brasil / epidemiologia
Estudos Transversais
Fêmea
Infecções por HIV / epidemiologia
HIV-1
Hepacivirus
Hepatite C / epidemiologia
Humanos
Triagem em massa
Vigilância da População
Gravidez
Complicações na Gravidez Infecciosa / epidemiologia
Complicações na Gravidez Infecciosa / virologia
Cuidados pré-natais
Prevalência
Fatores de Risco
Saúde da mulher
Adulto jovem
Autor
Afiliación
Federal University of Goiás. Faculty of Medicine. Goiás, Brazil.
Federal University of Goiás. Faculty of Medicine. Goiás, Brazil.
Federal University of Goiás. Faculty of Medicine. Goiás, Brazil.
Secretaria de Saúde do Estado de Goiás. Associação de Pais e Amigos dos Excepcionais de Goiânia – APAE. Goiânia, GO, Brazil.
Secretaria de Saúde do Estado de Goiás. Associação de Pais e Amigos dos Excepcionais de Goiânia – APAE. Goiânia, GO, Brazil.
Secretaria de Saúde do Estado de Goiás. Associação de Pais e Amigos dos Excepcionais de Goiânia – APAE. Goiânia, GO, Brazil.
Federal University of Goiás. Institute of Tropical Medicine and Public Health. Goiás, Brazil.
Federal University of Goiás. Institute of Tropical Medicine and Public Health. Goiás, Brazil.
Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.
Federal University of Goiás. Institute of Tropical Medicine and Public Health. Goiás, Brazil.
Federal University of Goiás. Faculty of Medicine. Goiás, Brazil.
Federal University of Goiás. Faculty of Medicine. Goiás, Brazil.
Secretaria de Saúde do Estado de Goiás. Associação de Pais e Amigos dos Excepcionais de Goiânia – APAE. Goiânia, GO, Brazil.
Secretaria de Saúde do Estado de Goiás. Associação de Pais e Amigos dos Excepcionais de Goiânia – APAE. Goiânia, GO, Brazil.
Secretaria de Saúde do Estado de Goiás. Associação de Pais e Amigos dos Excepcionais de Goiânia – APAE. Goiânia, GO, Brazil.
Federal University of Goiás. Institute of Tropical Medicine and Public Health. Goiás, Brazil.
Federal University of Goiás. Institute of Tropical Medicine and Public Health. Goiás, Brazil.
Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.
Federal University of Goiás. Institute of Tropical Medicine and Public Health. Goiás, Brazil.
Resumen en ingles
BACKGROUND:
Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in Central Brazil.
METHODS:
Screening and counselling for HIV and HCV infections was offered free of charge to all pregnant women attending antenatal clinic (ANC) in the public health system, in Goiania city (~1.1 million inhabitants) during 2004-2005. Initial screening was performed on a dried blood spot collected onto standard filter paper; positive or indeterminate results were confirmed by a second blood sample. HCV infection was defined as a positive or indeterminate sample (EIA test) and confirmed HCV-RNA technique. HIV infection was defined according to standard criteria. Factors associated with HIV and HCV infections were identified with logistic regression. The number needed to screen (NNS) to prevent one case of infant HIV infection was calculated using the Monte Carlo simulation method.
RESULTS:
A total of 28,561 pregnant women were screened for HCV and HIV-1 in ANC. Mean maternal age was 23.9 years (SD = 5.6), with 45% of the women experiencing their first pregnancy. Prevalence of HCV infection was 0.15% (95% CI 0.11%-0.20%), and the risk increased with age (p < 0.01). The prevalence of anti-HIV infection was 0.09% (95% CI 0.06%-0.14%). Black women had a 4.9-fold (95% CI 1.42-16.95) greater risk of HIV-1 infection compared to non-black women. NNS to prevent one case of infant HIV infection ranged from 4,141 to 13,928.
CONCLUSION:
The prevalence of HIV and HCV infections were low among pregnant women, with high acceptability rates in the opt-in strategy in primary care. Older maternal age was a risk factor for HCV and antenatal HCV testing does not fulfill the requirements for screening recommendation. The finding of higher risk of HIV-1 infection among black women despite being in consonance with the HIV-1 ethnic pattern in some American regions cannot be ruled out to be a surrogate marker of socio-economic condition.
Palabras clave en portugues
Vírus da imunodeficiência humanaMulher grávida
Infecção pelo Vírus da Imunodeficiência Humana
Mulher negra
Resultado Indeterminado
Palabras clave en ingles
Human Immunodeficiency VirusPregnant Woman
Human Immunodeficiency Virus Infection
Black Woman
Indeterminate Result
DeCS
AdolescenteAdulto
Idade
Fatores Brasil / epidemiologia
Estudos Transversais
Fêmea
Infecções por HIV / epidemiologia
HIV-1
Hepacivirus
Hepatite C / epidemiologia
Humanos
Triagem em massa
Vigilância da População
Gravidez
Complicações na Gravidez Infecciosa / epidemiologia
Complicações na Gravidez Infecciosa / virologia
Cuidados pré-natais
Prevalência
Fatores de Risco
Saúde da mulher
Adulto jovem
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