[Management of Infants Born to HIV-Infected Mothers: Eighteen Years of Single-Center Experience]

The most common route of transmission of human immunodeficiency virus (HIV) in children is perinatal transmission. HIV can be transmitted from mother to baby during pregnancy, delivery and breastfeeding. This study aimed to evaluate the characteristics of mothers and babies born to HIV-infected mothers and the methods applied to prevent perinatal HIV transmission and their outcomes. Data of babies born to HIV-infected mothers who were followed up at our tertiary hospital between January 2007 and December 2024 were retrospectively analyzed. Demographic and perinatal information of the patients, breastfeeding status, antiretroviral (ARV) prophylaxis, presence of congenital anomalies, HIV infection of the parents, characteristics of the mothers regarding HIV infection and pregnancy course were recorded. In our study, 65 of the 120 (54.2%) babies born to HIV-infected mothers were male. Of the patients, 62.5% (n= 75) were referred from other centers. Nineteen (15.8%) cases were born preterm and 11 (9.2%) cases were born small for gestational age. Ninety-one (75.8%) of the cases were born via cesarean section. Congenital cardiac anomalies were detected in two (1.7%). It was observed that 70 (58.3%) of the mothers were diagnosed before pregnancy, 40 (33.3%) during pregnancy and 10 (8.3%) at birth. The majority of mothers (59.2%) were between the ages of 20-30 and 26.7% were foreign nationals. ARV treatment was initiated in 70 (58.3%) of the mothers prior to pregnancy and in 30 (25%) during pregnancy. Of the mothers, 73.3% (n= 88) had HIV-1 RNA values < 20 copies/mL and 82.5% (n= 99) had CD4 counts ≥ 200 cells/mm3 in the last trimester. Of these cases, 82 (68.3%) were infants of low-risk mothers and 38 (31.7%) were infants of high-risk mothers. Despite being high risk, 15 cases received only zidovudine prophylaxis due to problems in drug supply. Appropriate prophylaxis could not be provided to five babies referred from external centers due to their late applications (days 3, 5, 2, 3, 29). HIV-RNA values were positive in the follow-up of four (3.1%) of our cases. It is possible to reduce and eliminate perinatal HIV transmission by using effective measures. This study highlights the importance of identifying the problems experienced by referred babies, providing more education on this issue and providing prophylactic drugs that are suitable for newborn formulation.