(P275) National trends of Mother-to-child transmission of HIV, hepatitis B, and syphilis in Brazil from 2011 to 2021

Background: Elimination of mother-to-child transmission (MTCT) of HIV, hepatitis B, and syphilis is a challenge in Brazil. Many policies have been implemented since 1986, but there are still important gaps. The objective of this study was to describe the trends of MTCT in Brazil and evaluate the gaps and perspectives in this scenario.

Methods: This is a descriptive study conducted with secondary data publicly available in the information systems of the Brazilian Ministry of Health regarding data on HIV, syphilis, and hepatitis B in pregnant women and children from 2011 to 2021.

Results: HIV and hepatitis B have had constant rates over the years in pregnant women, with the detection rates around 0.5/1,000 live birth (LB) and 2.5/1.000LB, respectively. The same did not happen with syphilis, which has shown an increasing line in the last decade. In 2011, the detection rate of syphilis in pregnancy was 4.7/1,000LB, and in 2021 it reached 27.1/1,000LB. Regarding the trends in children, an important decrease was observed in HIV/AIDS (incidence rate from 0.17/1,000 in 2011 to 0.04/1,000 in 2021) and Hepatitis B (incidence rate from 0.9/1,000LB in 2011 to 0.5/1,000LB in 2021). For congenital syphilis, there is a continuous increase, being 3.3/1,000LB in 2011 and 9.9/1,000LB in 2021. Data from the HIV clinical monitoring cascade showed in 2017, a total of 77% of pregnant women were diagnosed, 94% were in treatment and 74% presented viral suppression, and in 2021 81% of them were diagnosed, 95% were in treatment, and 77% with viral suppression. For syphilis, 82.5% of pregnant women were treated with benzathine penicillin, and in 2011 88.7%. The historical series of hepatitis B vaccination coverage in children has been decreasing over the years, it was 95.9% in 2013 and reached 68.2% in 2021.

Conclusion: These data show many gaps and some perspectives in the MTCT program in Brazil. The country is close to reaching MTCT HIV elimination but there are many challenges regarding HBV and syphilis. These data can be used to organize the strategies to enable the improvement of the Brazilian response to MTCT elimination of HIV, hepatitis B, and syphilis.