9TH EUROPEAN AIDS CONFERENCE (EACS) 1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP October 25 - 29, 2003 Warsaw, Poland

Background of Study: Systematic identification of infected pregnant women and application of preventive strategies has dramatically reduced HIV-1 perinatal transmission in developed countries. Nevertheless, some children and their mothers are still diagnosed subsequently.

Objectives: To describe the characteristics, management and outcomes of HIV vertical transmission over a 16-year period.

Methods: Prospective study of children born to HIV-infected women from January 1987 to December 2002 at two teaching hospitals in Barcelona.. Clinical records from a pediatric unit in a reference center.

Results: 447 infants were identified. Protocol ACTG 076 was implemented on October 1994, elective cesarean section in 1997, and HAART in 1998. Vertical transmission rate decreased from 14.9% (34/228) in the years prior to prophylactic ZDV to 3.7% (4/107) in the period 1995-1999 and 0.9% (1/112) thereafter. The last 5 infected children are currently alive, asymptomatic, receive HAART and remain free from AIDS (2 A1 and 3 N1). From October 1994, 17 additional cases were diagnosed. Their mothers were neither aware of their HIV infection nor identified during pregnancy (13 not tested and 1 HIV negative at the beginning of gestation), rejected prophylaxis² or did not control the gestation¹. Three infants died from PCP, 6 have AIDS (5 C1 and 1 B3) and 5 are classified as B1¹, B2¹ and B3³.

Conclusions: Early identification of HIV infection in pregnant women must be emphasized: prophylactic measures lower the risk of transmission to almost-zero rate, and infants who become infected present with mild clinical conditions and good short to moderate term prognosis.

Presenting Author: Dr Emília Sánchez, Catalan Agency for Health Technology Assessment and Research, Parc Sanitari Pere Virgili - Edifici Mestral, 1a planta - Esteve Tarrades, 30, 08023, Barcelona, Spain, Phone: 34-93-2594235

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