Determinantes de la transmisión vertical del VIH en Cataluña (1997-2001): ¿es posible su eliminación?

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Vives, C. Álvarez-Dardet, P. Caballero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Vives" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Álvarez-Dardet" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Caballero" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911103717464?idApp=WGSE" "url" => "/02139111/0000001700000004/v1_201310251607/S0213911103717464/v1_201310251607/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Determinantes de la transmisión vertical del VIH en Cataluña (1997-2001): ¿es posible su eliminación?" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "275" "paginaFinal" => "282" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Ramos, M.T. García-Fructuoso, J. Almeda, J. Casabona, O. Coll, C. Fortuny" "autores" => array:8 [ 0 => array:3 [ "nombre" => "F." "apellidos" => "Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "M.T." "apellidos" => "García-Fructuoso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:4 [ "nombre" => "J." "apellidos" => "Almeda" "email" => array:1 [ 0 => "jalmeda@ceescat.hugtip.scs.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Casabona" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "O." "apellidos" => "Coll" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "C." "apellidos" => "Fortuny" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 6 => array:2 [ "colaborador" => "por el grupo NENEXP" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 7 => array:1 [ "colaborador" => "el grupo ad hoc de infección pediátrica por VIH en Cataluña" ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "CEESCAT. Hospital Universitari Germans Trias i Pujol. Badalona. Barcelona" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Corporació Sanitària Clínic. Barcelona" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona. España" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "FIPSE, Proyecto n.° 3081/99" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Centre d'Estudis Epidemiològics de l'HIV/sida a Catalunya. Hospital Universitari Germans Trias i Pujol. Carretera de Canyet, s/n. 08916 Badalona. Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Determinants of HIV mother-to-child transmission in Catalonia, Spain [1997-2001]: is it possible to eliminate it?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-11-11" "fechaAceptado" => "2003-03-10" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268727" "palabras" => array:5 [ 0 => "Infección por VIH" 1 => "Transmisión vertical" 2 => "Prevención" 3 => "Terapia antirretroviral" 4 => "Profilaxis" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268728" "palabras" => array:5 [ 0 => "HIV infection" 1 => "Vertical transmission" 2 => "Prevention" 3 => "Antiretroviral therapy" 4 => "Prophylaxis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "ObjetivosIdentificar y describir los factores que han hecho posible la existencia de nuevas infecciones de VIH por transmisión vertical desde la implementación del tratamiento antirretroviral en la gestante seropositiva (1997-2001) en Cataluña. MétodosRevisión sistemática de casos identificados en servicios de pediatría de todos los hospitales de Cataluña. ResultadosSe identificaron 28 casos de infección pediátrica por VIH: 9, 9, 8, 2 y 0 por año de nacimiento de 1997 a 2001, respectivamente. De 16 madres con diagnóstico de infección por VIH conocido antes o durante el embarazo, 9 realizaron profilaxis antirretroviral durante éste (5 con buena adhesión, uno desconocido y el resto con mala adhesión) y 7 no realizaron profilaxis (6 por rechazo y uno no se conoce). De 12 diagnosticadas después del parto, 5 fueron embarazos no controlados y el resto poco o bien controlados. De estos últimos, en 6 no se practicó serología para VIH y en uno fue negativa en el primer trimestre. ConclusionesLa transmisión vertical del VIH en Cataluña ha disminuido en los últimos años, pero se han producido infecciones por la mala implementación en algún caso de las medidas preventivas conocidas. Debería ofrecerse la prueba diagnóstica para VIH a toda gestante no sólo en el primer trimestre de embarazo sino también al final, si se sospecha exposición al virus, y en caso de gestaciones no controladas hay que usar pruebas diagnósticas de lectura rápida en la sala de partos." ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "ObjectivesTo identify and describe the factors that have led to new cases of HIV infection through mother-to-child transmission since the introduction of antiretroviral therapy in HIVseropositive pregnant women (1997-2001) in Catalonia. MethodsSystematic review of cases identified in the pediatric services of all the hospitals in Catalonia. ResultsTwenty-eight cases of pediatric HIV infection were identified: 9, 9, 8, 2 and 0 per year of birth from 1997 to 2001, respectively. Of 16 mothers with a diagnosis of known HIV infection before or during pregnancy, nine underwent antiretroviral prophylaxis during pregnancy (compliance was good in five, unknown in one and poor in one) and seven did not undergo prophylaxis (six refused it and no information was available in one). Of 12 mothers diagnosed after delivery, pregnancy was not monitored in five and was little or well-monitored in the remaining seven. Of mothers with well-monitored pregnancy, a serological HIV test was not performed in six and was negative in the first trimester in one. ConclusionsMother-to-child transmission of HIV has decreased in the last few years in Catalonia, but infections have sometimes occurred through poor implementation of preventive measures. Pregnant women should be offered an HIV diagnostic test not only in the first trimester but also at the end of pregnancy if HIV exposure is suspected. 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