Sahar Faghih1, Elizabeth Secord. 1. 1Division of Allergy and Immunology, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA.
Abstract
BACKGROUND: Undiagnosed HIV during pregnancy leads to increased perinatal infection. Four cases of adolescents/young adults with HIV contracted during pregnancy, after initial negative HIV testing, led to 4 cases of perinatal HIV, which were diagnosed only after AIDS-defining illness occurred in infants. These cases were missed despite HIV testing during pregnancy. This identifies a change in pattern for perinatal infection: increased adolescent/young adult HIV leading to increased perinatal risk. METHODS: A 10-year retrospective chart review on HIV-positive infants in an urban referral center. Charts were reviewed for timing of maternal HIV testing and reason for infant HIV diagnosis. RESULTS: Twenty infected infants were referred over a 10-year period. Four HIV-infected infants were identified within a 2-year time frame at the end of the 10-year period. The 4 mothers were HIV negative, based on early peripartum testing (3 in first trimester and 1 in second trimester) and became infected or seroconverted during pregnancy after initial HIV test. The mothers diagnosed were all under the age of 25. CONCLUSIONS: Rapid HIV testing at the time of delivery, despite a negative HIV result in early pregnancy, will prevent the delay in HIV diagnosis in both the mother and the infant and thus decrease HIV transmission from mother to child.
BACKGROUND: Undiagnosed HIV during pregnancy leads to increased perinatal infection. Four cases of adolescents/young adults with HIV contracted during pregnancy, after initial negative HIV testing, led to 4 cases of perinatal HIV, which were diagnosed only after AIDS-defining illness occurred in infants. These cases were missed despite HIV testing during pregnancy. This identifies a change in pattern for perinatal infection: increased adolescent/young adult HIV leading to increased perinatal risk. METHODS: A 10-year retrospective chart review on HIV-positive infants in an urban referral center. Charts were reviewed for timing of maternal HIV testing and reason for infant HIV diagnosis. RESULTS: Twenty infectedinfants were referred over a 10-year period. Four HIV-infectedinfants were identified within a 2-year time frame at the end of the 10-year period. The 4 mothers were HIV negative, based on early peripartum testing (3 in first trimester and 1 in second trimester) and became infected or seroconverted during pregnancy after initial HIV test. The mothers diagnosed were all under the age of 25. CONCLUSIONS: Rapid HIV testing at the time of delivery, despite a negative HIV result in early pregnancy, will prevent the delay in HIV diagnosis in both the mother and the infant and thus decrease HIV transmission from mother to child.
Authors: Marion W Carter; Joan M Kraft; Kendra Hatfield-Timajchy; Margaret C Snead; Larisa Ozeryansky; Amy M Fasula; Linda J Koenig; Athena P Kourtis Journal: AIDS Patient Care STDS Date: 2013-12 Impact factor: 5.078