[Neonatal outcomes of prevention of vertical HIV transmission; 15 years of experience in a non-university HIV centre].
OBJECTIVE
To evaluate the neonatal outcomes of the policy for the prevention of vertical HIV transmission in a non-university HIV centre.


METHODS
Retrospective, descriptive study.


METHODS
We analysed the HIV status of newborns of HIV-positive mothers during pregnancy in the period between 1 January 1995 and 31 December 2010 in St. Elisabeth Hospital, Tilburg, the Netherlands and compared these results with the Dutch HIV monitoring foundation (SHM) registration data.


RESULTS
Eighty-seven children from 84 pregnancies and their 71 HIV-positive mothers were included. Compared with SHM data, more women were African, younger at HIV diagnosis and had less resistance to the usual combination antiretroviral therapy (cART). In line with SHM data, the percentage of elective caesarean sections declined in the study period. There were fewer preterm births than in SHM data. There were no significant differences between preterm birth (p = 0.18), SGA (p = 0.25) or congenital abnormality (p = 0.45) and detectable HIV-RNA or cART use during pregnancy. During 10 (12%) pregnancies the mother presented to the HIV centre too late. At the age of 18 months, all 72 tested children were HIV negative. Of the 15 children lost to follow-up, 8 (9%) left to an unknown destination.


CONCLUSIONS
All newborns of HIV-positive mothers were HIV negative, 12% of the HIV-positive mothers presented too late and 9% of the children disappeared from medical control. These results emphasize the importance of better communication between HIV centres, medical services of asylum centres and first-line obstetric care for female asylum seekers and their children.
UMC St Radboud, afd. Huisartsgeneeskunde, Nijmegen.
Christa A
CA
Veen
Marjo E E
ME
van Kasteren
Cora A
CA
Fiedeldeij
Marien H J
MH
Kuipers
Pim J
PJ
van Dijken
Charles C
CC
Obihara
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D009426:Netherlands; D054238:Perinatal Mortality; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000517:prevention & control*; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D019380:Anti-HIV Agents