AEGiS-14IAC: Management of maternal hiv diagnosed late in pregnancy.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Management of maternal hiv diagnosed late in pregnancy.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no.. B10225)

Lyons F, Hopkins S, Butler K, Mulcahy F
St. James's Hospital, Dublin, Ireland

BACKGROUND: Late diagnosis of maternal HIV in pregnancy presents multiple challenges. There has been a dramatic rise in the numbers of pregnant women presenting, particularly in those diagnosed late in pregnancy. The mean gestation for antenatal HIV diagnosis from January to December 2001 was 26 weeks (w). A protocol for managing late presenters is presented.

METHODS: Since 1998 a database of HIV infected pregnant women has been maintained. Classification is according to time of diagnosis: "pre-conception", "early" =<28w, "late" =>28<36w, "very late" =>36w, "in labour", "postnata", & "refuses therapy". Group, immunological & virological markers, determine specific management.

RESULTS: Of 180 deliveries between Jan '98 - Dec '01, there have been 2 transmissions (1%) with all other infants having at least one negative HIV PCR test at ≥3 months of age. From Jan - Dec '01there were 51 pregnancies: 19 (37%) in women previously known to be HIV-1 infected and 32 (63%) diagnosed at antenatal screening. Of the 32 diagnosed antenatally, 15 (47%) were diagnosed early, 8 (25%) were diagnosed late and 9 (28%) were diagnosed very late. All women with a CD4 count of ≤ 300 x 10(6)/L are commenced on 3 ART after the first trimester. The management of women with CD4 count of > 300 x 10(6)/L presenting >28w is outlined in the Table below. All women are offered IV AZT as per PACTG 076 and advised not to breastfeed. [table: see text]

Keywords: AEGIS, HIV Infections, HIV Seropositivity, CD4 Lymphocyte Count, Zidovudine, Mothers, HIV-1, Pregnancy Complications, Infectious, Breast Feeding, Pregnancy Outcome, Prenatal Diagnosis, Pregnancy Trimester, First, Parturition, Pregnancy, Pregnant Women, Human, Female, Infant, Diagnosis, organization & administration

020707
B10225

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.