Persistently high perinatal transmission of HIV: assessment of risk factors.
BACKGROUND
Despite dramatic decreases in rates of perinatal mother-to-child-transmission (PMTCT) of HIV in the United States, rates in some groups remain above the national average. Our objective was to examine factors contributing to a high rate of PMTCT of HIV.


METHODS
We conducted a retrospective chart review of HIV-exposed infants and their mothers referred to the University of Texas-Houston Pediatric HIV Clinic from January 2000 to June 2007.


RESULTS
Of 367 newborns studied, 22 (6%) acquired HIV infection perinatally. Associated risk factors included inadequate prenatal care, failure to receive antiretroviral therapy during pregnancy, detectable viral load and intravenous drug abuse.


CONCLUSIONS
The composite rate of PMTCT in this high risk cohort was at least 3-fold higher than expected from the current standard of care. Reduction of rates of PMTCT in our population will require ensuring access to appropriate prenatal care, including delivery of antiretroviral therapy and addressing issues of illicit drug use.
From the *Division of Infectious Diseases; †Division of Pediatric Nephrology and Hypertension; and ‡Division of Adolescent Medicine, The University of Texas Medical School, Houston, TX.
Gabriela
G
Del Bianco
Cynthia S
CS
Bell
Laura J
LJ
Benjamins
Norma
N
Pérez
Gilhen
G
Rodriguez
James R
JR
Murphy
Gloria P
GP
Heresi
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
D019380:Anti-HIV Agents