12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

WHY ARE CHILDREN STILL BEING INFECTED WITH HIV? EXPERIENCES IN PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV IN A COMPLEX SOUTH LONDON UNIVERSITY HOSPITAL POPULATION

HIV Med 2006; 7(Suppl. 1):1 (abstract no. O4)

Candice McDonald, Jack Lambert, Tanya Welz, Daya Nayagam, Mary Poulton and Jan Welch
King’s College Hospital, London, UK

AIMS: Despite recent advances in efforts to reduce mother-to-child transmission (MTCT) of HIV, there are still children becoming infected. To understand this further, we report on the prevention of MTCT at this hospital between 1993 and 2004.

METHODS: Prospective data collection on all HIV-infected women seen for antenatal care since 1993.

RESULTS: 296 pregnancies to 274 women. 153/274 women (55.8%) were diagnosed from routine antenatal screening. 6/287 (2.1%) pregnancies with adequate follow-up resulted in HIV infection in the infant. We describe the six cases in more detail and highlight relevant points: case 1, illustrating prematurity; case 2, late presentation at 38 weeks gestation; case 3, a missed opportunity for a woman who did not attend follow up; case 4, co-infection with falciparum malaria and TB; case 5, early in utero infection, ART started at 27 weeks; case 6, acute seroconversion during pregnancy. 4/6 children were infected in utero.

CONCLUSIONS: The low transmission rate of 2% in the multicultural population served by this hospital attests to the efforts of a multidisciplinary care team dedicated to the care of this frequently hard-to-reach population. More importantly, in utero infection in these children may have been avoided by starting antiretroviral therapy at an earlier stage than is suggested by BHIVA guidelines.

2006-03-29
O4

Copyright © 2006 - 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