Clinical and Epidemiologic Characteristics of a Cohort of HIV-Infected Mother-Infant Pairs During 21 Years.

Autor:	Illán Ramos M; Department of Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain.; CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Prieto Tato LM; Department of Paediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain., Guillén Martín S; CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.; Department of Paediatrics, Hospital Universitario de Getafe, Madrid, Spain., Navarro Gómez ML; CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.; Department of Paediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Escosa García L; Department of Paediatrics, Hospital Universitario La Paz, Madrid, Spain., Roa Francia MÁ; Department of Paediatrics, Hospital Universitario de Móstoles, Madrid, Spain., Beceiro Mosquera J; Department of Paediatrics, Hospital Universitario Príncipe de Asturias, Madrid, Spain., Olabarrieta Arnal I; Department of Paediatrics, Hospital Universitario Severo Ochoa, Madrid, Spain., Muñoz Gálligo E; Department of Gynecology, Hospital Universitario 12 de Octubre, Madrid, Spain., Viñuela Benéitez MC; Department of Gynecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Regidor Sáez FJ; Department of Paediatrics, Hospital Universitario Fundación Alcorcón, Madrid, Spain., Mazariegos Orellana D; Department of Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain., Fuentes Ferrer M; Department of Gynecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Berzosa Sánchez A; Department of Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain.; CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Callejas Caballero I; Department of Paediatrics, Hospital Universitario de Getafe, Madrid, Spain., Ramos Amador JT; Department of Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain.; CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; and.; Complutense University of Madrid, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2022 Dec 15; Vol. 91 (5), pp. 479-484.
DOI:	10.1097/QAI.0000000000003085
Abstrakt:	Background: HIV infection continues to be a worldwide public health problem. After the introduction of effective preventive measures, perinatal transmission dramatically decreased. Our aim was to assess the sociodemographic changes in pregnant women living with HIV infection and trends in perinatal transmission rates over time. Setting: The Madrid cohort of HIV-infected mother-infant pairs is a multicenter, prospective, observational, and cohort study that collects information on HIV-infected pregnant women and their children. Methods: Information on clinical-epidemiological characteristics of HIV-infected pregnant women until delivery and their children from 9 public hospitals was included. Data were collected from a standardized questionnaire from medical records. The results were classified in 3 periods: period 1 (P1) 2000-2006, period 2 (P2) 2007-2013, and period 3 (P3) 2014-2020. Results: A total of 1521 women living with HIV and 1548 newborns were included. In P1, most mothers (75.8%) were Spanish, whereas in P2 and P3 there was a predominance of foreign origin [62.8% and 70.5% respectively ( P < 0.01)]. The percentage of women with antiretroviral treatment before pregnancy increased significantly in P3 ( P < 0.01). The proportion of Caesarean sections decreased over time ( P < 0.01): 66.2% (n = 472) in P1, 54.9% (n = 245) in P2, and 46.7% (n = 141) in P3. The percentage of preterm and low birth weight newborns showed a statistically significant decrease. Even though there were no statistically significant differences ( P = 0.154), a decrease in cases of perinatal infection was observed (1.6% in P1, 1.3% in P2 and 0.3% in P3). Conclusions: The epidemiologic characteristics of pregnant women with HIV infection have changed over time in our setting, with an increase of non-Caucasian, heterosexual, and perinatally infected mothers. Although there are still perinatal infections, especially in vulnerable populations such as immigrant women, transmission rate has markedly decreased in recent years and is still of major concern. Prevention measures should be reinforced in the most socially disadvantaged groups. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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