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SONIA I. ARBONA, PHD, SHARON K.
MELVILIE, MD, MPH,I. CELINE HANSON, MD, JANET E. SQUIRES, MD, MARILYN
DOYLE, MD, TERENCE I. DORAN, MD, PHD, JANAK A. PATEL, MD, GILBERTO A.
HANDAL, MD, SAMISTHA B. HAUGER,MD,DONALD K, MURPHEY, MD AND KENNETH
DOMINGUEZ,MD
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ABSTRACT
Background.
The Pediatric Spectrum of HIV Diseases (PSD) project has been
collecting data on HIV-exposed children in Texas since 1989.
These data have now been analyzed
to describe mother-to child transmission in Texas and to provide
much needed information on the magnitude of the pediatric HIV
epidemic in the state.
Methods. We examined trends in the
numbers of perinantally exposed children and perinatally acquired
cases of HIV in the Texas PSD cohort.
We calculated transmission rates
and relative risks for 656 children born from January ,1995 to July,
1998, that received all or the ACTG 076 regimen.
Results. Only a small
proportion(38%) of pairs of an HIV-infected mother and her
HIV-exposed child received the full AIDS Clinical Trial Group 076
(ACTG 076) regimen;only 73% of the mothers received at least some
prenatal care. In recent years, however, the numbers of perinatally
exposed children and perinatally acquired cases of HIV have
decreased in Texas. Univariate analyses showed that a reduction in
the vertical transmission of HIV was associated with receipt of a
full ACTG 076 regimen, receipt of a partial ACTG 076 regimen and
residence in Dallas Country.
Conclusions. Findings identify a
gap in meeting the health care needs of pregnant HIV- infected women
and suggest missed opportunities to prevent mother-to-child
transmission of HIV. At the same time this study confirms progress
in prevention efforts to reduce mother-to-child transmission of HIV
in Texas.
Pediatr Infect Dis
J, 2001;20:602-6
Copyright 2001 by
lippincott Williams &Wilkins, Inc. |
