Document 2420
 DOCN  M94A2420
 TI    Vertical transmission risk (VTR) of HIV-1 in Brazil: the impact of low
       loss to follow-up.
 DT    9412
 AU    Tess B; Rodrigues LC; Duarte G; Mussi-Pinhata MM; Cervi MC; Newell ML;
       Instituto de Saude, SP, Brazil.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):308 (abstract no. PC0160). Unique
       Identifier : AIDSLINE ICA10/94370155
 AB    OBJECTIVES: 1. To estimate the VTR of HIV-1 in Ribeirao Preto, Brazil.
       2. To investigate the impact of low loss to follow up on the VTR of
       HIV-1. METHODS: An on-going retrospective (1988 to 1992) cohort study
       identified 112 HIV-positive mothers tested antenatally or at delivery at
       the University Hospital in Ribeirao Preto, Brazil. Children older than
       18 months were assessed for HIV-infection through a serologic test
       (ELISA). Infant deaths were classified as indeterminate (children with
       unknown HIV infection status), HIV-related and non-HIV-related. A
       previous estimate of the VTR was 29.5% (95% CI 20 to 39) and it was
       based on a partially overlapping cohort but without intensive follow up.
       RESULTS: Of 112, intensive searching resulted in contacting 97 (86.6%)
       mother-child pairs; 2 study subjects refused to be tested and 6 children
       were classified as indeterminate when they died. Seventy one children
       were seronegative, 18 seropositive (7 of them died of AIDS). The VTR in
       this cohort was 20.2% (95% CI 11.8 to 28.5). Of 23 children who had been
       previously lost to follow up before 18 months of age and who were found
       through the intensive searching, 22 were seronegative for HIV-1.
       CONCLUSIONS: The VTR of HIV-1 in Ribeirao Preto (20.2%) was closer to
       the risks estimated in Europe and the USA than to the risks estimated in
       Africa. The large majority of children who lost contact with the health
       services and who were found through an intensive searching were HIV-1
       seronegative. Less comprehensive follow up would have led to a much
       higher estimate of the VTR of HIV-1 in this cohort.
 DE    Brazil  Cohort Studies  Female  Human  HIV Infections/*TRANSMISSION
       *HIV-1  Infant, Newborn  Pregnancy  *Pregnancy Complications, Infectious
       Retrospective Studies  Risk Factors  MEETING ABSTRACT

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