Manejo de la infección materna con VIH y del recién nacido expuesto

Autores/as

  • Carlos Eduardo Fonseca
  • Franklyn Edwin Prieto

DOI:

https://doi.org/10.18597/rcog.560

Resumen

El VIH/SIDA afecta cada vez más a las mujeres, lo que aumenta la posibilidad de transmisión perinatal. La detección temprana del VIH mediante el acceso a la consejería y prueba voluntaria durante el control prenatal facilitan el tratamiento anti-retroviral oportuno que disminuye la transmisión durante el embarazo y el parto, y en el puerperio, asociado a la lactancia materna. En la presente revisión se condensan los principales aspectos del manejo de la infección materna con VIH y del recién nacido expuesto. La aplicación de un protocolo integral de atención facilita la disminución de la transmisión a niveles menores de 2%.

Biografía del autor/a

Carlos Eduardo Fonseca

Docente de Pediatría, Universidad Surcolombiana. Neiva, Huila, Colombia.

Franklyn Edwin Prieto

Coordinador Nacional, Proyecto Nacional de la Reducción de la Transmisión Madre Hijo de VIH. Bogotá DC, Colombia. 

Referencias bibliográficas

Onusida. Informe sobre la epidemia mundial de SIDA 2004. Cuarto informe mundial. Ginebra: Onusida; 2004.

Steinbrok R. The AIDS epidemic in 2004. N Engl J Med 2004;351:115-7.

Prieto F. Veinte años del VIH en Colombia, 1983-2003. Datos de la vigilancia epidemiológica. Inf Quinc Epidem Nac 2003;8:355-64.

Garcia-Bernal R, Klaskala W, Castro J, Zhang G, Baum M. VIH/AIDS epidemic in Colombia: regional differences in epidemic trends. AIDS 1997;11:1297-8.

Mock PA, Shaffer N, Bhadrakom C, Siriwasin W, Chotpitayasunondh T, Chearskul S, et al. Maternal viral load and timing of mother-to-child HIV transmission, Bangkok, Thailand. Bangkok Collaborative Perinatal HIV Transmission Study Group. AIDS 1999;13:407-14.

Fowler MG, Simonds RJ, Roongpisuthipong A. Update on perinatal HIV transmission. Pediatr Clin North Am 2000;47:21-38.

Institute of Medicine, National Research Council. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: National Academy Press; 1999.

Ministerio de Salud (Colombia). Resolución 00412 de 2000. Por la cual se establecen las actividades, procedimientos e intervenciones de demanda inducida y obligatorio cumplimiento y se adoptan las normas técnicas y guías de atención para el desarrollo de las acciones de protección específica y detección temprana y la atención de enfermedades de interés en salud pública. Guías de atención No. 11: VIH/sida.

Centers for Disease Control and Prevention. Revised guidelines for HIV counseling, testing, and referral. MMWR Recomm Rep 2001;50:1-57.

Gwinn M, Redus MA, Granade TC, Hannon WH, George JR. HIV-1 serologic test results for one million newborn dried-blood specimens: assay performance and implications for screening. J Acquir Immune Defic Syndr 1992;5:505-12.

Celum CL, Coombs RW, Lafferty W, Inui TS, Louie PH, Gates CA, et al. Indeterminate human immunodeficiency virus type 1 Western blots: seroconversion risk, specificity of supplemental tests, and an algorithm for evaluation. J Infect Dis 1991;164:656-64.

Jackson JB, MacDonald KL, Cadwell J, Sullivan C, Kline WE, Hanson M et al. Absence of HIV infection in blood donors with indeterminate Western blot tests for antibody to HIV-1. N Engl J Med 1990;322:217-22.

Centers for Disease Control and Prevention. Revised recommendations for HIV screening of pregnant women. MMWR Recomm Rep 2001;50:63-85.

Minkoff H, O’Sullivan MJ. The case for rapid HIV testing during labor. JAMA 1998; 279:1743-4.

Grobman WA, Garcia PM. The cost-effectiveness of voluntary intrapartum rapid human immunodeficiency virus testing for women without adequate prenatal care. Am J Obstet Gynecol 1999;181:1062-71.

Kane B. Rapid testing for HIV: why so fast? Ann Intern Med 1999;131:481-3.

King SM; American Academy of Pediatrics Committee on Pediatric AIDS; American Academy of Pediatrics Infectious Diseases and Immunization Committee. Evaluation and treatment of the human immunodeficiency virus 1- exposed infant. Pediatrics 2004;114:497-505.

Mofenson LM, Munderi P. Safety of antiretroviral prophylaxis of perinatal transmission for HIV-infected pregnant women and their infants. J Acquir Immune Defic Syndr 2002;30:200-15.

Watts DH. Management of human immunodeficiency virus infection in pregnancy. N Engl J Med 2002;346:1879-91.

Krist AH. Obstetric care in patients with HIV disease. Am Fam Physician 2001;63:107-16, 121-2.

Mofenson LM, Committee on Pediatric AIDS. Technical Report: perinatal human immunodeficiency virus testing and prevention of transmission. Pediatrics 2000;106:e88.

Krist AH, Crawford-Faucher A. Management of newborns exposed to maternal HIV infection. Am Fam Physician 2002;65:2049-56.

Watts DH. Management of human immunodeficiency virus Infection in pregnancy. N Engl J Med 2002;346:1879-91.

Brocklehurst P, Volmink J. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev 2002;(2):CD003510.

Public Health Service Task Force. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1 Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United States. Disponible en: http://AIDSinfo.nih.gov. Consultado 7 de enero de 2005.

U.S. Public Health Service (USPHS) and Infectious Diseases Society of America (IDSA). 1999USPHS/IDSA Guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. MMWR Recomm Rep 1999;48:1-59, 61-6.

Moss W, Clements J, Halsey N. Immunization of children at risk of infection with Human Immunodeficiency Virus. Bull World Health Organ 2003;81:61-70.

Mofenson LM, Lambert JS, Stiehm ER, Bethel J, Meyer WA 3rd, Whitehouse J, et al. Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. Pediatric AIDS Clinical Trials Group Study 185 team. N Engl J Med 1999;341:385-93.

Garcia PM, Kalish LA, Pitt J, Minkoff H, Quinn TC, Burchett SK, et al. Maternal levels of plasma human immunodeficiency virus type 1 RNA and the risk of perinatal transmission. Women and Infants Transmission Study Group. N Engl J Med 1999;341:394-402.

Thea DM, Steketee RW, Pliner V, Bornschlegel K, Brown T, Orloff S, et al. The effect of maternal viral load on the risk of perinatal transmission of HIV-1. New York City Perinatal HIV Transmission Collaborative Study Group. AIDS 1997;11:437-44.

Mayaux MJ, Dussaix E, Isopet J, Rekacewicz C, Mandelbrot L, Ciraru-Vigneron N, et al. Maternal virus load during pregnancy and mother-to-child transmission of human immunodeficiency virus type 1: the French perinatal cohort studies. J Infect Dis 1997;175:172-5.

Van Dyke RB, Korber BT, Popek E, Macken C, Widmayer SM, Bardeguez A, et al. The Ariel Project: a prospective cohort study of maternal-child transmission of human immunodeficiency virus type 1 in the era of maternal antiretroviral therapy. J Infect Dis 1999;179:319-28.

Harris NS, Thompson SJ, Ball R, Hussey J, Sy F. Zidovudine and perinatal human immunodeficiency virus type 1 transmission: a population-based approach. Pediatrics 2002;109(4):e60.

King SM, American Academy of Pediatrics Committee on Pediatric AIDS; American Academy of Pediatric Infectious Diseases and Immunization Committee. Evaluation and treatment of the human immunodeficiency virus-1--exposed infant. Pediatrics 2004;114:497-505.

Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O’Sullivan MJ, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 1994;331:1173-80.

Cooper ER, Charurat M, Mofenson L, Hanson IC, Pitt J, Diaz C, et al. Combination anti-retroviral strategies for the treatment of pregnant HIV-1 infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr 2002;29:484-94.

Sperling RS, Shapiro DE, Coombs RW, et al. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1996; 335:1621-9.

Talaie H, Nava-Ocampo AA, Koren G. Antiretroviral treatment of maternal HIV infection. Can Fam Physician 2004;50:865-8.

Ioannidis JP, Abrams EJ, Ammann A, Bulterys M, Goedert JJ, Gray L, et al. Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads <1000 copies/ml. J Infect Dis 2001;183:539-45.

Guay LA, Musoke P, Fleming T, Bagenda D, Allen M, Nakabiito C, et al. Intrapartum and neonatal single dosis nevirapine compared with zidovudine for prevention of mother to child transmission of HIV-1 in Kampala, Uganda : HIVNET 012 randomised trial. Lancet 1999;354:795-802.

Jourdain G, Ngo-Giang-Huong N, Le Coeur S, Bowonwatanuwong C, Kantipong P, Leechanachai P, et al. Intrapartum exposure to nevirapine and subsequent maternal responses to nevirapine-based antiretroviral therapy. N Engl J Med 2004;351:229-40.

The Petra Study Team. Efficacy of three short-course regimens of zidovudine and lamivudine in preventing early and late transmission of HIV-1 from mother to child in Tanzania, South Africa, and Uganda (Petra study); a randomised double-blind placebo-controlled trial. Lancet 2002;359:1178-86.

Wade NA, Birkhead GS, Warren BL, Charbonneau TT, French PT, Wang L, et al. Abbreviated regimens of zidovudine prophylaxis and perinatal transmission of the human immunodeficiency virus. N Engl J Med 1998;339:1409-14.

Dorenbaum A, Cunningham CK, Gelber RD, Culnane M, Mofenson L, Britto P, et al. Two-dose intrapartum/newborn nevirapine and standard antiretroviral therapy to reduce perinatal HIV-1 transmission: a randomized trial. JAMA 2002;288:289-98.

Van Rompay KK, Otysula MG, Marthas ML, Miller CJ, McChesney MB, Pedersen NC. Immediate zidovudine treatments protects simian immunodeficiency virus-infected newborn macaques against rapid onset of AIDS. Antimicrob Agents Chemother 1995;39:125-31.

Dunn DT, NewellML, Mayaux MJ, Kind C, Hutto C, Goedert JJ, et al. Mode of delivery and vertical transmission of HIV-1: a review of prospective studies. Perinatal AIDS Collaborative Transmission Studies. J Acquir Immune Defic Syndr 1994;7:1064-6.

Kuhn L, Bobat R, Coutsouidis A, Moodley D, Coovadia HM, Tsai WY, et al. Cesarean deliveries and maternal-infant HIV transmission: results from a prospective study in South Africa. J Acquir Immune Defic Syndr Hum Retrovirol 1996;11:478-83.

The International Perinatal HIV Group. The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1: a meta-analysis of 15 prospective cohort studies. N Engl J Med 1999;340:977-87.

The European Mode of Delivery Collaboration. Elective caesarean-section versus vaginal delivery in prevention of vertical HIV-1 transmission: a randomised clinical trial. Lancet 1999;353:1035-9.

van Ham MA, van Dongen PW, Mulder J. Maternal consequences of caesarean section: a retrospective study of intra-operative and post-operative maternal complications of caesarean section during a 10-year-period. Eur J Obstet Gynecol Reprod Biol 1997;74:1-6.

Read J, Tuomala R, Kpamegan E, Zorrilla C, Landesman S, Brown G, et al. Mode of delivery and postpartum morbidity among HIV infected women: The Women and Infants Transmission Study (WITS). J Acquir Immune Defic Syndr 2001;26:236-45.

Rodriguez EJ, Spann C, Jamieson D, Lindsay M. Postoperative morbidity associated with caesarean delivery among human immunodeficiency virus-seropositive women. Am J Obstet Gynecol 2001; 184:1108-11.

Landers DV, Duarte G. Mode of delivery and the risk of vertical transmission of HIV-1. N Engl J Med 1999;341:205.

Landesman SH, Kalish LA, Burns DN, Minkoff H, Fox HE, Zorrilla C, et al. Obstetrical factors and the transmission of human immunodeficiency virus type 1 from mother to child. The Women and Infants Transmission Study. N Engl J Med 1996;334:1617-23.

Bulterys M, Fowler MG, Van Rompay KK, Kourtis AP. Prevention of mother-to-child transmission of HIV-1 through breast feeding: past, present, and future. J Infect Dis 2004;189:2149-53.

Breastfeeding and HIV International Transmission Study Group. Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis. J Infect Dis 2004;189:2154-66.

Embree JE, Njenga S, Datta P, Nagelkerke NJ, Ndinya-Achola JO, Mohammed Z, et al. Risk factors for postnatal mother-child transmission of HIV-1. AIDS 2000;14:2535-41.

Coutsouides A, Pillay K, Kuhn L, Spooner E, Tsai WY, Coovadia HM; South African Vitamin A Study Group. Methods of feeding and transmission of HIV-1 from mothers to children by 15 months of age : prospective cohort study from Durban, South Africa. AIDS 2001;15:379-87.

Rollins N, Meda N, Becquet R, Coutsoudis A, Humphrey J, Jeffrey B, et al. Preventing postnatal transmission of HIV-1 through breastfeeding: modifying infant feeding practices. J Acquir Immune Defic Syndr 2004;35:188-95.

Kiarie JN, Richardson BA, Mbori-Ngacha D, Nduati RW, John-Stewart GC. Infant feeding practices of women in a perinatal HIV-1 prevention study in Nairobi, Kenya. J Acquir Immune Defic Syndr 2004;35:75-81.

Read JS; American Academy of Pediatrics Committee on Pediatric AIDS. Human milk, breastfeeding, and the transmission of human immunodeficiency virus type 1 in the United States. Pediatrics 2003;112:1196-205.

Dunn DT, Brand CD, Krivine A, et al. The sensitivity of HIV-1 DNA polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission. AIDS 1995;9:F7:11.

Owens DK, Holodniy M, McDonald TW, Scout J, Sonnad S. A meta-analytic evaluation of the polymerase chain reaction for the diagnosis of HIV infection in infants. JAMA 1996;275:1342-8.

Steketee RW, Abrams EJ, Thea DM, Brown TM, Lambert G, Orloff S, et al. Early detection of perinatal human immunodeficiency virus (HIV) type 1 infection using HIV RNA amplification and detection. New York City Perinatal HIV Transmission Collaborative Study. J Infec Dis 1997;175:707-11.

Rouet F, Montcho C, Rouzioux C, Leroy V, Msellati P, Kottan JB, et al. ANRS. Early diagnosis of pediatric HIV-1 Infection among African breast-fed children using quantitative plasma HIV RNA assay. AIDS 2001;15:1849-56.

American Academy of Pediatrics. Comittee on Pediatric AIDS. Evaluation and medical treatment of the HIV-exposed infant. Pediatrics 1997;99:909-17.

Centers for Disease Control and Prevention. Guidelines for national human immunodeficiency virus case surveillance, including monitoring for human immunodeficiency virus infection and acquired immunodeficiency syndrome. MMWR Recomm Rep 1999;48:1-27, 29-31.

Atkinson WL, Pickering LK, Schwartz B, Weniger BG, Iskander JK, Watson JC; Centers for Disease Control and Prevention. General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). MMWR Recomm Rep 2002;51:1-35.

Stern JO, Robinson PA, Love J, Lanes S, Imperiale MS, Mayers DL. A comprehensive hepatic safety analysis of nevirapine in different populations of HIV infected patients. J Acquir Immune Defic Syndr 2003;34:S21-33.

Tuomala RE, Shapiro DE, Mofenson LM, Bryson Y, Culnane M, Hughes MD, et al. Antiretroviral therapy during pregnancy and the risk of an adverse outcome. N Engl J Med 2002;346:1863-70.

Cómo citar

1.
Fonseca CE, Prieto FE. Manejo de la infección materna con VIH y del recién nacido expuesto. Rev. Colomb. Obstet. Ginecol. [Internet]. 30 de marzo de 2005 [citado 2 de julio de 2022];56(1):68-81. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/560

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2005-03-30

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