Mother-to-child transmission of HIV infection in Craiova Regional Center

Abstract

HIV infection is still associated with high maternal, feto-neonatal and infant morbidity. Early detection of HIV infection during pregnancy and early initiation of antiretroviral therapy are correlated with obtaining an HIV viral load of less than 50 copies/ml, in which case the risk of maternal-fetal transmission of the infection is less than 0.5%. Objectives. To establish the maternal-fetal transmission rate of HIV infection among HIV-positive pregnant women registered in Craiova Regional Center for Monitoring and Evaluation of HIV/AIDS within „Victor Babeş” Clinical Hospital of Infectious Diseases and Pneumoftiziology of Craiova (CRC) and to identify some correlations between it and certain risk factors. Material and method. Retrospective study, during January 1st, 2014-December 31st, 2019, on 73 HIV-positive pregnant women, registered by Craiova Regional Center (CRC). For the patients included in the study group we analysed: demographic data, epidemiological data, clinical data, biological data, data provided by gynaecological and obstetrical examination, data on antiretroviral treatment (ART). The children were biologically evaluated until the age of 18 months. Results. We found a maternal-fetal transmission rate of 6.3%. For patients with complete prophylaxis measures, the maternal-fetal transmission rate was 3%. The application of complete prophylaxis measures was correlated with a low risk of vertical transmission of HIV infection (p = 0.006). The low adherence to ART was correlated with a high risk of maternal-fetal transmission of HIV infection (p = 0.02), detectable viral-HIV load (VL-HIV) (p = 0.0004) and advanced immunosuppression (p = 0.02). The disease stage of HIV-positive pregnant women was not correlated with the risk of vertical transmission of the infection (p = 1). The level of HIV viral load of mothers who gave birth to HIV-positive children was higher than in the general group and correlated with the maternal-fetal transmission (p = 0.04). Conclusions. The maternal-fetal transmission rate in the studied period was relatively high (6.3%), due to the incomplete application of prevention measures, 12 of the pregnant women being diagnosed during pregnancy or childbirth. The vertical transmission of HIV infection was correlated with detectable HIV viremia and low ART adherence in pregnant women.

Keywords

• hiv
• maternal-fetal
• transmission