Clínica de la infección por VIH en población pediátrica. Prevención de la transmisión maternoinfantil. Una revisión sistemática
DOI:
https://doi.org/10.26820/recimundo/9.(2).abril.2025.793-811Palabras clave:
VIH pediátrico, Transmisión vertical, Antirretrovirales, Prevención maternoinfantil, Infección infantilResumen
La infección por VIH en la población pediátrica sigue siendo un desafío de salud pública, especialmente en contextos con acceso limitado a intervenciones preventivas. La transmisión maternoinfantil representa la principal vía de infección en menores de cinco años. Esta revisión sistemática tuvo como objetivo analizar la evidencia reciente sobre las manifestaciones clínicas del VIH en niños y las estrategias efectivas para prevenir la transmisión vertical. Se realizó una revisión sistemática siguiendo las directrices PRISMA. Se aplicaron criterios PICOS: población (niños con VIH o en riesgo de transmisión maternoinfantil), intervención (prevención con antirretrovirales, controles perinatales, lactancia segura), comparadores (ausencia o variación de intervenciones), resultados (tasa de transmisión, evolución clínica), y diseño (ensayos clínicos, estudios observacionales, revisiones sistemáticas). Las bases de datos consultadas fueron PubMed, Scopus, Web of Science, SciELO y Cochrane Library. Se incluyeron artículos publicados entre 2006 y 2025, en inglés y español. La selección se realizó en tres fases: cribado de títulos/resúmenes, lectura de texto completo y evaluación de calidad metodológica. Se incluyeron 30 estudios. La evidencia muestra que la terapia antirretroviral combinada durante el embarazo, parto y lactancia reduce significativamente la transmisión vertical (<2%). Clínicamente, los niños infectados presentan infecciones oportunistas recurrentes y retraso en el desarrollo si no reciben tratamiento temprano. Las principales limitaciones fueron la heterogeneidad metodológica y la escasez de estudios longitudinales. Las intervenciones preventivas actuales son efectivas, pero su implementación desigual limita su impacto. Se requieren más estudios longitudinales en contextos de bajos recursos para mejorar la atención pediátrica y reducir la transmisión maternoinfantil.Descargas
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Derechos de autor 2025 María Andrea Del Rocío Betancourt Ruiz, Rodrigo Javier Mendoza Ramirez, Mercedes Ermelinda Palacios Aguirre, Washington Ricardo Beltran Rodriguez
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