OBJECTIVE

To assess whether neonates taken by elective cesarean from mothers infected with the Human Immunodeficiency Virus (HIV) have a lower frequency of positivity in a rapid test at birth than those born vaginally.

MATERIALS AND METHODS

Retrospective, observational, descriptive study. We reviewed the cases of women with reactive HIV test during pregnancy, who received prophylactic therapy with antiretroviral during the years 2014-2016. The cases are analyzed with reactive test at birth and results are compared between delivery and caesarean section.

RESULTS

In this studio, we analyzed 1,261 births, 1,245 women underwent caesarean section and 16 vaginal births. We observed 103 cases of babies with reactive HIV test at birth. Of these, 87 were born by caesarean section and 16 by vaginal delivery. 7% of births by caesarean section and 100% of those born by vaginal delivery, recorded reactive HIV test. The pregnant woman with HIV, who underwent elective cesarean section, showed a relative risk (RR) of .07 with a 95% confidence index (95% CI 0.06-0.09). The risk that a newborn by elective cesarean section present a reactive HIV test was between 6 and 9%.

CONCLUSONS

Elective cesarean reduces the risk of a reactive HIV test in the newborn. 93% of neonates obtained by caesarean section were tested negative for HIV. All neonates obtained vaginally presented a rapid test reactive to HIV even with suppressed viral load. The woman with HIV should ideally have undetectable viral load at birth. When it does not meet this requirement, it is suggested to consider the practice of an elective cesarean section as an absolute indication.

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