Pregnancy as an opportunity to diagnose human-immunodeficiency virus immigrant women in Catalonia.
Mother-to-child transmission (MTCT) is relevant in the global epidemiology of human-immunodeficiency virus (HIV), as it represents the main route of infection in children. The study objectives were to determine the rate of HIV-MTCT and its epidemiological trend between the Spanish-born and immigrant population in Catalonia in the period 2000-2014.



A prospective observational study of mother-child pairs exposed to HIV, treated in 12 hospitals in Catalonia in the period 2000-2014. HIV-MTCT rate was estimated using a Bayesian logistic regression model. R and WinBUGS statistical software were used.



The analysis included 909 pregnant women, 1,009 pregnancies, and 1,032 children. Data on maternal origin was obtained in 79.4% of women, of whom 32.7% were immigrants, with 53.0% of these from sub-Saharan Africa. The overall HIV-MTCT rate was 1.4% (14/1,023; 95% CI; 0.8-2.3). The risk of MTCT-HIV was 10-fold lower in women with good virological control (P=.01), which was achieved by two-thirds of them. The proportion of immigrants was significantly higher in the period 2008-2014 (P<.0001), for the HIV-diagnosis (P<.0001), and antiretroviral administration (P=.02) during pregnancy, and for undetectable viral load next to delivery (P<.001). There were no differences in the rate of MTCT-HIV among Spanish-born and immigrant women (P=.6).



There is a gradual increase in HIV pregnant immigrants in Catalonia. Although most immigrant women were diagnosed during pregnancy, the rate of MTCT-HIV was no different from the Spanish-born women.
Unidad de Enfermedades Infecciosas e Inmunodeficiencias Pediátricas, Servicio de Pediatría, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: tsorianoarandes@gmail.com.
Antoni
A
Soriano-Arandes
Unidad de Infectologia, Servei de Pediatria, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
Antoni
A
Noguera-Julian
FISABIO, Centro de Salud Pública de la Generalitat de Valencia, Valencia, España.
Mónica
M
López-Lacort
Unidad de Enfermedades Infecciosas e Inmunodeficiencias Pediátricas, Servicio de Pediatría, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
Pere
P
Soler-Palacín
Hospital Universitari del Mar, Universidad Autónoma de Barcelona, Barcelona, España.
Antonio
A
Mur
Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
María
M
Méndez
Hospital Universitari Josep Trueta, Girona, España.
Lluís
L
Mayol
Hospital Universitari Arnau de Vilanova, Lleida, España.
Teresa
T
Vallmanya
Centre d'Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT), Catalunya, España.
Jesús
J
Almeda
Centre d'Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT), Catalunya, España.
Dolors
D
Carnicer-Pont
Centre d'Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT), Catalunya, España.
Jordi
J
Casabona
Unidad de Infectologia, Servei de Pediatria, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
Claudia
C
Fortuny
D000328:Adult; D002648:Child; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
Epidemiology; Epidemiología; Gestación; Human-immunodeficiency syndrome; Immigration; Inmigración; Pregnancy; Public health; Salud pública; Transmisión vertical; Vertical transmission; Virus de la inmunodeficiencia humana