10th Anniversary Conference Of The British HIV Association [BHIVA] 15 – 17 April 2004, City Hall, Cardiff, UK

[AUTHOR(S):] GP Taylor¹, W Khan², L Navaratne³, F Martin⁴, L Sarner⁵, J White¹, C Walsh², Z Penn², EGH Lyall¹, Penn², D Mercey⁶, S O'Shea³, J Anderson⁴, A Fakoya⁵, DA Hawkins², A de Ruiter^3
1 St Mary's Hospital, ² Chelsea and Westminster Hospital, ³ St Thomas' Hospital, ⁴ Homerton University NHS Trust, ⁵ Newham Healthcare NHS Trust, and ⁶ Mortimer Market Centre, London, UK

BHIVA Conf 2004 Apr 15-17;10:O25

BACKGROUND: With HIV transmission rates of <1%, mothers and their carers now weigh the risk of additional interventions against potential benefit. In the absence of randomised controlled trials, cohort studies can be informative.

METHODS: Notes were reviewed for all women diagnosed HIV seropositive ante-partum between the start of 1998 and the end of 2002 in six centres. The women were offered zidovudine (ZDV) monotherapy or three or more antiretroviral drug combinations (CART) and prelabour Caesarian section (PLCS) according to BHIVA guidelines.

RESULTS: 350 women delivered 362 babies; 84% were black African; 91 took ZDV of whom 80% delivered by PLCS and 10% an emergency Caesarian section (EmgCS). 71% of women on CART also delivered by PLCS and a further 16% by EmgCS. Pre-eclampsia was four times more common in women on CART. No significant trends in PLCS rates or prescribing of ZDV versus CART over 5 years appeared. HIV status is available for 235 babies, among whom one is infected (0.5%), eight are HIV- indeterminate and 22 are missing tests.

CONCLUSIONS: Pre-eclampsia and EmgCS rates were higher in women taking CART. The continued high PLCS rate in women on CART may reflect the paucity of data on transmission among women on CART with undetectable HIV viraemia.

PRESENTING AUTHOR: L Navaratne

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Copyright © 2004 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD