Katharina Singer1,2, Ulf Schulze-Sturm3, Irene Alba-Alejandre4, Bettina Hollwitz5, Thi Thanh Truc Nguyen3, Franz Sollinger2, Josef Eberle6,7, Johannes Hübner2,7, Robin Kobbe3, Orsolya Genzel-Boroviczény1, Ulrich von Both8,9. 1. Division of Neonatology Campus Innenstadt, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany. 2. Division of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany. 3. Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany. 5. Department of Obstetrics and Prenatal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 6. Division of Virology, National Reference Center for Retroviruses, Max von Pettenkofer-Institute for Hygiene and Clinical Microbiology, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany. 7. German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany. 8. Division of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany. ulrich.von.both@med.uni-muenchen.de. 9. German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany. ulrich.von.both@med.uni-muenchen.de.
Abstract
PURPOSE: Due to early antenatal screening and treatment, HIV mother-to-child transmission (MTCT) rarely occurs in Germany. The study aimed to investigate the impact on prevalence of HIV infection in the antenatal population and the incidence of late-presenting HIV-infected mothers attributable to increased numbers of refugees. METHODS: Retrospective analysis and comparison were performed for all deliveries in HIV-infected pregnant women presenting to medical care in Munich (southern Germany) and Hamburg (northern Germany) covering two time periods, A (2010-2012) and B (2013-2015). RESULTS: In Munich, deliveries in HIV-infected pregnant women increased 1.6-fold from period A (n = 50) to B (n = 79) with late-presenting cases rising significantly from 2% (1/50) in period A to 13% (10/79) in B. In contrast, late-presenting cases in Hamburg decreased from 14% (14/100) in period A to 7% (7/107) in B, while the total number of HIV-infected women giving birth remained stable. From 2010 to 2015, one late-presenting pregnant woman transmitted HIV in Munich by presumed in utero mode of infection (case reviewed here), while no MTCT occurred in Hamburg. CONCLUSIONS: HIV infections diagnosed late in pregnancy and leading to delayed ART initiation are rising in Munich compared to Hamburg. Antenatal care of HIV-infected pregnant women in Munich appears to have been more affected by the recent refugee influx than Hamburg. Our study highlights the importance of screening all pregnant women for HIV early in pregnancy and providing timely health care access for pregnant refugees and asylum seekers to effectively prevent MTCT in Germany.
PURPOSE: Due to early antenatal screening and treatment, HIV mother-to-child transmission (MTCT) rarely occurs in Germany. The study aimed to investigate the impact on prevalence of HIV infection in the antenatal population and the incidence of late-presenting HIV-infected mothers attributable to increased numbers of refugees. METHODS: Retrospective analysis and comparison were performed for all deliveries in HIV-infected pregnant women presenting to medical care in Munich (southern Germany) and Hamburg (northern Germany) covering two time periods, A (2010-2012) and B (2013-2015). RESULTS: In Munich, deliveries in HIV-infected pregnant women increased 1.6-fold from period A (n = 50) to B (n = 79) with late-presenting cases rising significantly from 2% (1/50) in period A to 13% (10/79) in B. In contrast, late-presenting cases in Hamburg decreased from 14% (14/100) in period A to 7% (7/107) in B, while the total number of HIV-infectedwomen giving birth remained stable. From 2010 to 2015, one late-presenting pregnant woman transmitted HIV in Munich by presumed in utero mode of infection (case reviewed here), while no MTCT occurred in Hamburg. CONCLUSIONS:HIV infections diagnosed late in pregnancy and leading to delayed ART initiation are rising in Munich compared to Hamburg. Antenatal care of HIV-infected pregnant women in Munich appears to have been more affected by the recent refugee influx than Hamburg. Our study highlights the importance of screening all pregnant women for HIV early in pregnancy and providing timely health care access for pregnant refugees and asylum seekers to effectively prevent MTCT in Germany.
Entities:
Keywords:
HIV; Late presenting; MTCT; Mother-to-child transmission; Refugees
Authors: L Ryom; C Boesecke; V Gisler; C Manzardo; J K Rockstroh; M Puoti; H Furrer; J M Miro; J M Gatell; A Pozniak; G Behrens; M Battegay; J D Lundgren Journal: HIV Med Date: 2015-11-08 Impact factor: 3.180
Authors: Diana F Clarke; Edward P Acosta; Matthew L Rizk; Yvonne J Bryson; Stephen A Spector; Lynne M Mofenson; Edward Handelsman; Hedy Teppler; Carolee Welebob; Deborah Persaud; Mae P Cababasay; JiaJia Wang; Mark Mirochnick Journal: J Acquir Immune Defic Syndr Date: 2014-11-01 Impact factor: 3.731