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Ongoing Maternal-Child Transmission of HIV in an Urban Area, 2003-2012
Richard M Rutstein1, Kathleen M Volkman1, Sirisha Bonda1
1Divisions of General Pediatrics and Special Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.
Insights
Preventing mother-to-child HIV transmission requires timely prenatal care and antiretroviral therapy (ART). Early ART initiation during pregnancy significantly reduces infant HIV infection rates, highlighting the importance of accessible prenatal services.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Mother-to-child transmission of Human Immunodeficiency Virus (HIV) is preventable through interventions during pregnancy and childbirth.
- Understanding the prevalence of vertical HIV transmission in urban settings is crucial for targeted prevention strategies.
Purpose of the Study:
- To determine the prevalence of vertical HIV transmission in a cohort of HIV-exposed infants.
- To describe cases of vertical HIV infection identified during and after the neonatal period.
Main Methods:
- Retrospective cohort study design.
- Inclusion of HIV-exposed infants receiving care at an urban referral site between July 1, 2003, and June 30, 2012.
Main Results:
- Out of 516 HIV-exposed infants, 9 (1.7%) were infected with HIV.
- HIV infection rate was 0.7% with prenatal antiretroviral (ARV) therapy versus 9.3% without.
- 46% of infants diagnosed with HIV at delivery lacked prenatal care.
Conclusions:
- Enhanced access to prenatal care and Human Immunodeficiency Virus (HIV) testing is essential.
- Initiation of antiretroviral (ARV) therapy during pregnancy is a key strategy to eliminate infant HIV infections.
Background And Objective:
Mother-to-child transmission of HIV can be prevented by prenatal and peripartum interventions. We sought to determine the prevalence of vertical HIV transmission in an urban cohort of HIV-exposed infants and describe cases of vertical HIV infection presenting during and after the neonatal period.
Methods:
This retrospective cohort study included HIV-exposed infants born between July 1, 2003, and June 30, 2012, who received care at an urban referral site.
Results:
There were 516 infants with HIV exposure known by the time of delivery; 9 of these infants (1.7%; 95% confidence interval: 0.8%-3.3%) were HIV infected. The HIV infection rate was 0.7% for those receiving prenatal antiretroviral (ARV) therapy and 9.3% for those receiving only intrapartum and/or postnatal ARV therapy. Among those diagnosed with HIV at delivery, 46% received no prenatal care.
Conclusions:
Our data suggest that strategies to eliminate infant HIV infections ought to include ensuring better access to prenatal care, HIV testing, and ARV therapy initiation during pregnancy.
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