AEGiS-15IAC: Prevention of vertical transmission of HIV in Russia.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Prevention of vertical transmission of HIV in Russia.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10287)

Sokolova EV, Pokrovskiy VV, Ladnaia NN, Detkova NV
Russian Federal AIDS Centre, Moscow, Russian Federation

BACKGROUND: The prevalence of HIV-infection among pregnant women in Russia increased from 0,6 in 1996 to 114,8 in 2002. Our objective was to study efficacy of prophylaxis of mother-to-child transmission (MTCT) of HIV.

METHODS: Information about the prophylaxis of MTCT among 415 pregnant women with HIV in Russia was reported to the Russian Federal AIDS Center from 70 regions of the Russian Federation (81,3% of all regions).

RESULTS: The mean percentage of vertical transmission of HIV prior to the year 2000 was 19,3%. Among the group of women which received no prophylaxis and continued to breast feed (10,8% of the study group), the rate of vertical transmission was 51,1%. The prevention of vertical transmission through antiretroviral regimens were used in only 38,6% of all cases, and the rate of vertical transmission in this group was 6,9%. Cesarean delivery was used in 7% of cases, and no reliable preventive effect of this measure was found (p=1,00). Among the balance of women who received no antiretroviral intervention, a significant role was played by counselling. In cases where there was no ongoing counselling provided and formula feeding was the only preventive measure used the rate of child infection was 27,5%. If counselling was provided the risk of MTCT was significantly lower 13,5% (p=0,009). 70% of the HIV-positive pregnant women were treated for birth canal infections during pregnancy. The rate of mother-to-child transmission among women who were treated for birth canal infections was lower than those who were left untreated (10,6% vs. 22,9%) (p=0,005).

CONCLUSIONS: The most effective measure for the prevention of vertical transmission of HIV was antiretroviral treatment, combined with replacement of breast-feeding with infant formula. Counselling to women and the treatment of birth canal infections during pregnancy were also significantly measures in reducing the vertical transmission of HIV.

Keywords: AEGIS, Disease Transmission, Vertical, Acquired Immunodeficiency Syndrome, HIV Seropositivity, HIV Infections, Breast Feeding, Antiretroviral Therapy, Highly Active, Prevalence, Mothers, Counseling, Cesarean Section, Delivery, Obstetric, Russia, Pregnant Women, Humans, Female, Pregnancy, Child, Infant, prevention & control, transmission, surgery, therapy, drug therapy

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