Nechaeva O.B.¹, Skachkova E.I.², Podymova A.S.³, Popkova G.G.³, Eysmont N.V.^3
1 - Federal Public Health Institute, Moscow
² - Ministry of Health and Social Development , Moscow
³ - Sverdlovsk regional antitubercular dispensary , Ekaterinburg

Sverdlovsk region takes the first place in Russia in the number of children who were born by HIV-infected mothers. More than 40 % of HIV-infected women gave birth to children. HIV- infected mothers gave birth to children mainly at ages till 25 years (74.8 %), never were married (65.6 %); women as a rule were not registered in women’s health clinic (38.3 %) and did not receive antiretroviral therapy (81.4 %) during pregnancy.

In the region, 68.9 % of children born by HIV-infected mothers have got anti-TB vaccination , mainly with modified vaccine of Calmette and Guerin (92.7 %), often in a maternity hospital (44.2 %). Among children who have got anti- TB vaccination at early ages, "curve " in the tuberculine tests was less often (0.7 % against 4.4 %, P <0.01) and tuberculosis morbidity was registered rarely (0.8 % against 5.5 %, P <0.001), general case mortality was lower (1.0 % against 4.8 %, P <0.01).

In children born by HIV-infected mothers and vaccinated with vaccine of Calmette and Guerin, HIV-infection was registered significantly more rarely than in children who were not anti-TB vaccinated (19.2 % against 44.3 %, P <0.001). In spite of the fact that vaccinated with vaccine of Calmette and Guerin HIV-infected children born by HIV-infected mothers have rarely got antiretroviral therapy during child births, they have HIV-infection developed later than in children who have not got TB vaccination, that is, in the ages of till 1 year –in 25.2 % and 45.0 % of all cases (P <0.002) respectively, in the ages of 2 years and more in 53.9 % and 22.5 % of all cases (P <0.001) respectively. vaccine of Calmette and Guerin not only promotes reduction in TB contamination and morbidity , but also increases terms of HIV-infection development , and in some cases prevents contamination in children born by HIV-infected mothers.

Key words: tuberculosis, HIV-infection , vaccine of Calmette and Guerin, children born by HIV-infected mothers.

References

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