Children born to HIV-1-infected women in Sweden in 1982-2003: trends in epidemiology and vertical transmission.
To describe the HIV-1 epidemic among childbearing women and their children in Sweden, a population-based analysis of data on all known mother-child pairs in Sweden with perinatal exposure to HIV-1 1982-2003 was conducted. The mother-to-child transmission (MTCT) rate in children prospectively followed from birth decreased from 24.7% in 1985-1993 to 5.7% in 1994-1998 and 0.6% in 1999-2003. The use of antiretroviral treatment of the mother during pregnancy and/or prophylactic antiretroviral intervention increased from 2.3% to 91.6% during the same period, and the elective cesarean delivery rate increased from 8.0% to 80.3%. No MTCT of HIV-1 occurred in Sweden after 1999.Fifty-one vertically HIV-1-infected children aged 2.7 to 17.6 years were living in Sweden by 31 December 2003, 71% being treated with antiretroviral agents. No HIV-1-related child death has been reported in Sweden after 1996. The conclusion is that MTCT of HIV-1 can be almost eliminated when appropriate resources are available. A national pregnancy screening program for HIV-1 running since 1987 with a high acceptance rate and the implementation of measures to prevent MTCT since 1994 have resulted in a significant decrease in the number of infected children. Inasmuch as knowledge of the infection status of the mother is crucial for reduction in MTCT of HIV-1, continued antenatal screening is important even in a low-prevalence country such as Sweden.
Navér
Lars
L
Department for Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska University Hospital Huddinge, Sweden. lars.naver@ki.se
Lindgren
Susanne
S
Belfrage
Erik
E
Gyllensten
Katarina
K
Lidman
Knut
K
Gisslén
Magnus
M
Ehrnst
Anneka
A
Arneborn
Malin
M
Bohlin
Ann-Britt
AB
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology