Aspectos clínicos e epidemiológicos de gestantes vivendo com HIV atendidas no Hospital de doenças Tropicais da Universidade Federal do Tocantins

Abstract

Thousands of people have been infected with the human immunodeficiency virus (HIV) since the beginning of the epidemic, and several have died as a result of its complications, which has been growing in the female population due to the increase in heterosexual transmission. Women who are of reproductive age are more likely to become pregnant and when infected, there is a need for care to prevent maternal and child infection, which is responsible for the majority of the infection in children under 13 years old. A literature review on the topic was presented in this work, addressing the history of HIV infection, the etiology, epidemiology, pathogenesis, clinical aspects, diagnosis of the infection, treatment especially in pregnant women, and prevention and control measures both infection and vertical transmission. An epidemiological and clinical study was also presented in pregnant women with HIV who were seen at the Tropical Diseases Hospital of the Federal University of Tocantins (HDT-UFT) during the period from 2015 to 2019 in order to learn about the characteristics of the infected pregnant women. Data collection took place at HDT-UFT through the analysis of clinical records, in which, after tabulation, they were submitted to statistical analysis, considering the absolute and percentage frequency. For the qualitative variables, a dispersion study was carried out using Fisher's exact test and the Chi-square test, and for the quantitative variables, the F test was performed, using the treatments detectable and non-detectable viral load, whose type 1 error probability was 0.05. The average age of the 85 pregnant women was 26 years old, with the age group from 26 to 34 years old observed in most of them (48.24%). The predominant level of education was High School (37.64%) and the self-declared color was brown (91.76%). These were from three states: Tocantins (90.58%), Pará (7.06%) and Maranhão (2.35%), and they mostly had a steady partner (80%), most of whom were unaware of their status serological (44.11%). A significant difference was observed (p = 0.0001) between pregnant women aged ≥ 25 years and <25 years in relation to viral load. Approximately 56.47% of these were diagnosed with HIV before pregnancy, 45.88%, started follow-up in the first trimester of pregnancy and 5.88% contracted syphilis during pregnancy. The HIV viral load (CV-HIV) was undetectable in 57.65% of pregnant women, and the most used antiretroviral therapy (ART) (50.60%) in the treatment of HIV included the use of tenofovir (TDF), lamivudine ( 3TC) and efavirenz (EFZ), whose adherence comprised 85.90% of the studied pregnant women, with a dropout rate of 14.10%. There was a significant difference between the variables HIV diagnosis (p = 0.0133) and gestational trimester (p = 0.0001), which influenced the viral load of HIV. The importance of adhering to the recommendations of the Ministry of Health for the prevention of vertical transmission is observed in the fact that the majority of pregnant women are adherent to the treatment, have low levels of viral load, showing that they were concerned with their quality of life and that of the child, seeking rapid care and thus reducing the risk of transmission of the infection.