Prenatal screening and perinatal HIV transmission in Northern Alberta, 1999-2006.
OBJECTIVE
We evaluated the effectiveness of a program that includes routine opt-out prenatal HIV screening, combination antiretroviral therapy (ART), and a multidisciplinary team in preventing perinatal HIV transmission.


METHODS
A retrospective analysis was performed on HIV-infected pregnant women in northern Alberta, Canada, who delivered between January 1, 1999, and February 28, 2006.


RESULTS
Ninety-eight women had 113 deliveries. Forty-three percent were diagnosed with HIV infection through prenatal screening. Approximately 60% of HIV-infected pregnant women were Aboriginal, with 45% reporting alcohol use and 42% illicit drug use during pregnancy. The use of combination ART during pregnancy increased throughout the study period; 89% or more received combination ART from 2004 through 2006. Only 1 of the 111 infants (0.9%) was confirmed to be HIV infected, and that infant was born to a woman with no prenatal care.


CONCLUSIONS
High rates of HIV testing using an opt-out approach, combined with efforts by a multidisciplinary team, resulted in a low rate of perinatal HIV transmission in our cohort. The added value of retesting high-risk women late in pregnancy or with rapid HIV tests at the time of delivery should be explored.
Faculty of Pharmacy & Pharmaceutical Sciences, 3126 Dentistry/Pharmacy Centre, University of Alberta Edmonton, AB Canada T6G 2N8. chughes@pharmacy.ualberta.ca
Christine A
CA
Hughes
Dalyce
D
Zuk
Michelle
M
Foisy
Joan
J
Robinson
Ameeta E
AE
Singh
Stan
S
Houston
D000293:Adolescent; D000328:Adult; D000416:Alberta / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D007198:Indians, North American; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D011296:Prenatal Diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
D044966:Anti-Retroviral Agents