Epidemiological and clinical features of pregnant women with HIV: a 21-year perspective from a highly specialized regional center in southern Italy.
OBJECTIVE
To analyze the changes over two decades in HIV-infected pregnant women followed at a highly specialized regional center for antenatal care in southern Italy.


METHODS
Since 1985, all HIV-infected pregnant women attending our center have been monitored using progressively updated protocols.


RESULTS
By December 2006, 230 deliveries in 159 women had been monitored. Deliveries in HIV-infected women increased from 0.16% (4/2,499) of all deliveries in 1985 to 0.73% (15/2,042) in 2006. The sociodemographic profile of the women changed greatly over the study period, and there was a shift from injecting drug use to heterosexual contact as the main transmission route and an increased proportion of foreign women. Subsequent to improvements in clinical care, the proportion of infected pregnant women receiving antiretroviral treatment increased from 27% (17/63) before 1996 to 81% (63/78) in 2006, with a corresponding decrease in the mother-to-child transmission rate from 36% (16/44) to 0.6% (1/157).


CONCLUSIONS
The increasing number of HIV-infected pregnant women can be attributed to nonselective antenatal HIV screening, the spread of HIV infection through heterosexual contacts, and the desire of HIV-infected women to have children. In this context, highly specialized reference centers can play an important role in providing HIV-infected pregnant women with optimal care and in reducing mother-to-child transmission rates to very low levels.
Martinelli
Pasquale
P
Department of Gynecology and Obstetrics, Centre for STD and HIV/AIDS in Obstetrics and Gynecology, University of Naples Federico II, Napoli, Italy. martinel@unina.it
Agangi
Annalisa
A
Sansone
Matilde
M
Maruotti
Giuseppe Maria
GM
Buffolano
Wilma
W
Paladini
Dario
D
Pizzuti
Renato
R
Floridia
Marco
M
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007558:Italy / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D011256:Pregnancy Outcome / Q000453:epidemiology