Русский
The prevention of vertical HIV transmission and the problem of perinatal deaths in infants born to HIV-infected women
DOI: https://dx.doi.org/10.18565/epidem.2020.10.3.79-86
Kozyrina N.V., Ladnaia N.N., Shakhgildyan V.I., Ivanova L.A., Narsia R.S., Dementyeva L.A.
Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
Materials and methods. The 2017–2019 statistical data of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Ministry of Health of Russia, and the Russian Federal State Statistics Service on the prevention of vertical HIV transmission and on infant mortality rates were studied.
Results. Coverage of mother-child pairs with preventive measures changed slightly in 2017–2019, since high values (91%) were achieved just by 2017, but at the same time there was a clear trend towards a continued coverage increase (92.5% in 2018 and 93.5% in 2019). In 2019, the lowest risk for vertical HIV transmission (0.5% or less) was achieved in the infants of 5,559 (40.7%) women who had started antiretroviral therapy before pregnancy. Such women were 4654 (31.6%) in 2018 and 4004 (26.7%) in 2017. A total of 205,675 infants were born during the follow-up period. The presence of HIV infection was confirmed in 11,322 babies, including 165, 220, and 273 infants born in 2019, 2018, and 2017, respectively. There were data on deaths of 123 babies in the first year of their life in 2017; 31 (25.2%) of them were infected with HIV; and those on deaths of 132 infants in 2018; of whom 13 (9.8%) were HIV-infected. In 2019, a total of 91 infants died; 5 (5.5%) were diagnosed with HIV infection. Among infants born to HIV-infected women, the mortality rates per 1000 live births were 6.6, 8.9, and 8.2 in 2019, 2018, and 2017, respectively. At the same time, according to the Russian Federal State Statistics Service, the infant mortality rates in the general population were 26–43% lower than those in HIV-infected patients.
Conclusion. For positive changes in the prevention of mother-to-child transmission of HIV, it is necessary to expand treatment coverage among HIV-positive women of childbearing age; to widely introduce measures to work with pregnant women belonging to risk groups; to strengthen efforts to maintain adherence of pregnant women to follow-up and treatment. There is a need to further identify the factors influencing the increased mortality of young children, as well as to develop and implement measures to prevent the increased risk of perinatal and infant death, primarily to timely diagnose and treat the current spectrum of intrauterine infections.
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About the Autors
Nadezhda V. Kozyrina, Cand. Med. Sci., Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: nad-kozyrina@yandex.ru; ORCID: https://orcid.org/0000-0001-5134-0054
Natalya N. Ladnaia Cand. Biol. Sci., Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: nladnaia@hotmail.com; ORCID: https://orcid.org/0000-0003-2994-151X
Vasily I. Shakhgildyan, Cand. Med. Sci., Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: vishakh@yandex.ru; ORCID: https://orcid.org/0000-0002-8686-0487
Larisa A. Ivanova, Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; ORCID: https://orcid.org/0000-0002-7397-0652
Roza S. Narsia, Deputy Head for Economic Affairs and Medical Personnel Management, Specialized Research Department for AIDS Epidemiology and Prevention, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: rnarsiya@mail.ru
Larisa A. Dementyeva, Specialist in Economic Issues, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; e-mail: Dementeva_la@gsen.ru
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