El retraso del diagnóstico del VIH en embarazadas supone un peor pronóstico de la enfermedad en sus hijos, según un estudio de la Red Pediátrica para la Prevención, Detección Precoz y Tratamiento del VIH en niños del Programa Iberoamericano de Ciencia y Tecnología para el Desarrollo.
El estudio, liderado por un equipo del área de Enfermedades Infecciosas del CIBER (CIBERINFEC) y del Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), se publicó en la revista BMC Infectious Diseases, reseñó EFE.
Diagnosticar rápidamente las nuevas infecciones es fundamental para iniciar un tratamiento antirretroviral adecuado que evite la morbimortalidad infantil relacionada con la infección.
Sin embargo, a pesar de que los importantes esfuerzos de prevención han logrado reducir la transmisión del VIH de madre a hijo (TMI) en todo el mundo, todavía hay casos de infecciones pediátricas por VIH.
Diagnóstico del VIH
La transmisión del virus de la madre al hijo puede ocurrir en tres momentos: el embarazo, el parto, el puerperio y la lactancia.
Prevenir la transmisión en estas etapas es crucial y, para ello, las principales intervenciones son la terapia antirretroviral durante el embarazo y en el período neonatal, la cesárea antes del parto y la ruptura de membranas, en caso de carga viral detectable; y la contraindicación de la lactancia materna para las mujeres que viven con el VIH.
Aunque en América Latina se están haciendo esfuerzos en prevención del VIH pediátrico, éste sigue siendo uno de los objetivos del Desarrollo del Milenio que propone la Organización Mundial de la Salud (OMS).
La OMS estimó que, en 2010, 21 mil mujeres embarazadas eran VIH positivo en América Latina, y solo 10 mil 600 (50,5%) recibieron terapia antirretroviral; en ese año, 3 mil 400 niños menores de 15 años fueron diagnosticados con VIH.
Analizar los posibles fallos
En 2017, se contaba un número similar de mujeres seropositivas, de las cuales 15 mil 300 (72,9%) estaban recibiendo esta terapia.
El número de nuevos diagnósticos pediátricos de VIH es de un 29 %, gracias a la puesta en marcha de medidas de prevención de la trasmisión madre a hijo.
El objetivo de esta investigación era describir los casos de transmisión del VIH de madre a hijo en hospitales de referencia de América Latina para analizar los posibles fallos en las estrategias de prevención y en el retraso del diagnóstico para seguir avanzando en la mejora de estos parámetros.
Para ello, se diseñó un estudio multicéntrico y descriptivo de casos de TMI diagnosticados durante 2018 en 13 hospitales de referencia de 8 países (Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, México, Nicaragua y Panamá).
El trabajo incluyó datos de 81 niños y niñas con VIH.
Analizar los posibles fallos
Los resultados revelaron que menos del 3 % de las mujeres conocían su diagnóstico de VIH antes del embarazo, de las cuales sólo una había recibido tratamiento antirretroviral previo al embarazo.
Más del 80 % de ellas fueron diagnosticadas después del parto, el 8,7 % durante el embarazo y el 2,9 % en el propio parto, pero para entonces, casi la mitad de los niños (49,3 %) presentaba un estadio avanzado de la enfermedad.
«Si bien la transmisión del VIH de madre a hijo en América Latina ha disminuido en los últimos años, nuestra serie muestra que aún existen casos que indican fallos en la prevención, siendo un punto crítico para mejorar un diagnóstico más temprano de las mujeres embarazadas», señala Marisa Navarro, una de las coordinadoras de este estudio.
Pronóstico clínico
La mitad de los niños y niñas los diagnosticaron en un estadio avanzado de la enfermedad y el retraso en el diagnóstico materno conllevó un peor pronóstico clínico e inmunológico de estos menores, subraya.
Este trabajo se ha realizado en el marco de la Red Pediátrica para la Prevención, Detección Precoz y Tratamiento del VIH en niños (PLANTAIDS) del Programa Iberoamericano de Ciencia y Tecnología para el Desarrollo (CYTED).
La red PLANTAIDS agrupa a investigadores e investigadoras de 9 países de América Latina (Nicaragua, Guatemala, México, Honduras, Costa Rica, Panamá, Ecuador, Venezuela, El Salvador), con el apoyo de la red española de VIH pediátrica CoRISpe, el Instituto Italo Latinoamericano (IiLA), la red PENTA y el Programa ESTHER del Ministerio de Sanidad español.
Por Agencia
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