Background and Importance The rate of new HIV diagnoses due to vertical transmission (VT) in Spain is very low and the new cases are related to failures in the implementation of prevention measures.
Aim and Objectives The aims of study are to identify and quantify risk factors (RF) for VT in the prenatal, intrapartum and postnatal periods and to evaluate the adequacy of antiretroviral (ART) prophylaxis, the appearance of adverse events and follow-up during the first year of life.
Material and Methods A descriptive, retrospective and observational study was designed which included all the children who were followed up in the hospital during the 2010-2020 period. The main RFs that could contribute to VT were defined in the three periods and demographic and clinical variables of mothers and children were collected. The follow-up was recorded during the first year.
Results A total of 30 children, of 22 HIV + mothers, were included. They were young women, mostly from immigrant communities and without toxic habits. 17% of the pregnant women were diagnosed during the pregnancy controls and of the remaining, 20% did not take ART treatment at the beginning of pregnancy. At the time of birth, 34.5% had detectable viral loads (CV). Regarding children, 57% were born by cesarean section and 13% were premature. The RF detected correspond mainly to the prenatal period (62.5%), followed by the intrapartum (26.8%) and the postnatal period. The most frequent RFs were detectable CVs followed by premature rupture of membranes. All the children received prophylaxis that was well tolerated, observing discrepancies regarding the regimen received. All children could be analytically confirmed the absence of VT, in some cases after 18 months.
Conclusion and Relevance None of the newborns became infected with HIV. Although the majority of mothers carried out controls during pregnancy, the absence of ART before/during pregnancy stands out, together with detectable CVs as the main RF detected. Information campaigns are necessary for the prevention of VT viewing during pregnancy, as well as, training for professionals and constant updating of protocols to guarantee the correct management of children exposed to HIV.
Conflict of Interest No conflict of interest
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