Pathogens (Apr 2024)
Pregnancy Management in HIV Viral Controllers: Twenty Years of Experience
- Charlotte-Eve S. Short,
- Laura Byrne,
- Aishah Hagan-Bezgin,
- Rachael A. Quinlan,
- Jane Anderson,
- Gary Brook,
- Okavas De Alwis,
- Annemiek de Ruiter,
- Pippa Farrugia,
- Sarah Fidler,
- Eleanor Hamlyn,
- Anna Hartley,
- Siobhan Murphy,
- Heather Noble,
- Soonita Oomeer,
- Sherie Roedling,
- Melanie Rosenvinge,
- Luciana Rubinstein,
- Rimi Shah,
- Selena Singh,
- Elizabeth Thorne,
- Martina Toby,
- Brenton Wait,
- Liat Sarner,
- Graham P. Taylor
Affiliations
- Charlotte-Eve S. Short
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Laura Byrne
- School of Medicine, St Georges, University of London, London SW17 0RE, UK
- Aishah Hagan-Bezgin
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Rachael A. Quinlan
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Jane Anderson
- Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK
- Gary Brook
- London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK
- Okavas De Alwis
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
- Annemiek de Ruiter
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
- Pippa Farrugia
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
- Sarah Fidler
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Eleanor Hamlyn
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
- Anna Hartley
- Barts Health NHS Trust, London E1 1BB, UK
- Siobhan Murphy
- London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK
- Heather Noble
- Barts Health NHS Trust, London E1 1BB, UK
- Soonita Oomeer
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
- Sherie Roedling
- Central and North West London NHS Foundation Trust, London NW1 3AX, UK
- Melanie Rosenvinge
- Lewisham and Greenwich NHS Trust, London SE13 6LH, UK
- Luciana Rubinstein
- London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK
- Rimi Shah
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
- Selena Singh
- Barts Health NHS Trust, London E1 1BB, UK
- Elizabeth Thorne
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Martina Toby
- Barts Health NHS Trust, London E1 1BB, UK
- Brenton Wait
- Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK
- Liat Sarner
- Barts Health NHS Trust, London E1 1BB, UK
- Graham P. Taylor
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- DOI
- https://doi.org/10.3390/pathogens13040308
- Journal volume & issue
-
Vol. 13,
no. 4
p. 308
Abstract
(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (p = 0.10. Pre-2012 pregnancies were predominantly managed with ZDVm (28/35) with pre-labour caesarean section (PLCS) (24/35). Post-2012 4/14 received ZDVm and 10/14 triple ART, p = 0.002. Post-2012 mode of delivery was varied (5 vaginal, 6 PLCS and 3 emergency CS). No intrapartum ZDV infusions were given post-2012 compared to 11/35 deliveries pre-2012. During pregnancy, HIV was detected (> 50 copies/mL) in 14/49 pregnancies (29%) (median 92, range 51–6084). Neonatal ZDV post-exposure prophylaxis was recorded for 45/49 infants. No transmissions were reported. (4) Conclusion: UK practice has been influenced by the change in guidelines, but this has had little impact on CS rates.
Keywords
- elite HIV viral controller
- pregnancy
- antiretroviral therapy
- obstetric management
- HIV-1 vertical transmission
