Aids em crianças: considerações sobre a transmissão vertical

Phonological awareness abilities of a child with acquired immunodeficiency syndrome before and after speech therapy

The aim of the present study was to characterize the phonological awareness abilities of a child with Acquired Immunodeficiency Syndrome (AIDS) before and after speech-language therapy. The participant was a 6-year-old girl, first-grade Elementary School student, with AIDS acquired by vertical transmission. The child's phonological awareness abilities were evaluated using the Instrument of Sequential Evaluation of Phonological Awareness (CONFIAS). After this first evaluation, a closed therapeutic program (15 sessions) for phonological awareness was developed, consisting of activities for syllabic and phonemic levels. The CONFIAS was reapplied in the last session in order to investigate therapy effectiveness. In the pre-therapy assessment, the child scored 18 points in syllable tasks and 1 point in phoneme tasks, with a total score of 19 points. In the post-therapy assessment, the child scored 26 points in syllable tasks and 11 points in phoneme tasks, with a total score of 37 points. This study allowed us to characterize the performance of a child with AIDS in tasks of phonological awareness and the effectiveness of the therapeutic program. The score obtained before therapy was much lower than expected for the child's age, and presented significant improvement after speech-language therapy. Thus, professionals working with this population must be aware of therapeutic programs that approach phonological processing abilities in addition to other aspects.

Pharmaceutical care to pregnant women carrying human immunodeficiency virus

The purpose of this present study was to know the pharmacoepidemiological profile of pregnant women carrying HIV, the prevention actions against vertical transmission, and evaluate the service respecting the patients' level of satisfaction. It was developed a quali-quantitative longitudinal study, with the sample being composed by pregnant women carrying HIV attended at the Pharmaceutical Care Service of a public hospital of Fortaleza - state of Ceará, during the period between January and September, 2007. The data were collected by means of follow-up cards, patients' medical history and, finally, interviews to verify the users' level of satisfaction related to the service. Twenty seven pregnant and parturient women have participated in the study. The mean profile found was of a single woman, aged in the range between 18 and 28 years, of Caucasian race or dark colored, with familial revenue below the minimum wage, having elementary or high school, and being unemployed. It was observed that 77.8% (n=21) of patients followed all prevention strategies against maternal-infant transmission. Twenty nine drug related problems have been detected, out of which 51.7% (n=15) were resolved. The general level of satisfaction respecting the Pharmaceutical Care Service was quite satisfactory. By means of the Pharmaceutical Care Service, the pharmacist professional effectively collaborates for the correct utilization of medications, and this action results directly in a decrease of HIV vertical transmission.

Vertical human immunodeficiency virus type 1--HIV-1--transmission--a review

Several factors appear to affect vertical HIV-1 transmission, dependent mainly on characteristics of the mother (extent of immunodeficiency, co-infections, risk behaviour, nutritional status, immune response, genetical make-up), but also of the virus (phenotype, tropism) and, possibly, of the child (genetical make-up). This complex situation is compounded by the fact that the virus may have the whole gestation period, apart from variable periods between membrane rupture and birth and the breast-feeding period, to pass from the mother to the infant. It seems probable that an extensive interplay of all factors occurs, and that some factors may be more important during specific periods and other factors in other periods. Factors predominant in protection against in utero transmission may be less important for peri-natal transmission, and probably quite different from those that predominantly affect transmission by mothers milk. For instance, cytotoxic T lymphocytes will probably be unable to exert any effect during breast-feeding, while neutralizing antibodies will be unable to protect transmission by HIV transmitted through infected cells. Furthermore, some responses may be capable of controlling transmission of determined virus types, while being inadequate for controlling others. As occurrence of mixed infections and recombination of HIV-1 types is a known fact, it does not appear possible to prevent vertical HIV-1 transmission by reinforcing just one of the factors, and probably a general strategy including all known factors must be used. Recent reports have brought information on vertical HIV-1 transmission in a variety of research fields, which will have to be considered in conjunction as background for specific studies.