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Published on: October 31, 2010
Prenatal screening and perinatal HIV transmission in Northern Alberta, 1999-2006
Christine A Hughes1, Dalyce Zuk, Michelle Foisy
1Faculty of Pharmacy & Pharmaceutical Sciences, 3126 Dentistry/Pharmacy Centre, University of Alberta Edmonton, AB Canada T6G 2N8. chughes@pharmacy.ualberta.ca
Objectives:
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.
