title: Increased adolescent HIV infection during pregnancy leads to increase in perinatal transmission at urban referral center.
abstract: BACKGROUND
  Undiagnosed HIV during pregnancy leads to increased perinatal infection. Four cases of adolescents/young adults with HIV contracted during pregnancy, after initial negative HIV testing, led to 4 cases of perinatal HIV, which were diagnosed only after AIDS-defining illness occurred in infants. These cases were missed despite HIV testing during pregnancy. This identifies a change in pattern for perinatal infection: increased adolescent/young adult HIV leading to increased perinatal risk.
  
  
  METHODS
  A 10-year retrospective chart review on HIV-positive infants in an urban referral center. Charts were reviewed for timing of maternal HIV testing and reason for infant HIV diagnosis.
  
  
  RESULTS
  Twenty infected infants were referred over a 10-year period. Four HIV-infected infants were identified within a 2-year time frame at the end of the 10-year period. The 4 mothers were HIV negative, based on early peripartum testing (3 in first trimester and 1 in second trimester) and became infected or seroconverted during pregnancy after initial HIV test. The mothers diagnosed were all under the age of 25.
  
  
  CONCLUSIONS
  Rapid HIV testing at the time of delivery, despite a negative HIV result in early pregnancy, will prevent the delay in HIV diagnosis in both the mother and the infant and thus decrease HIV transmission from mother to child.
authors.affiliation: 1Division of Allergy and Immunology, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA.
authors.forename: Sahar
authors.initials: S
authors.lastname: Faghih
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Secord
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission*; D006786:Hospitals, Urban; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D010044:Outpatient Clinics, Hospital; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011295:Prenatal Care; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents