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The most recent version of this article was published on 1 January 2008

Arch Dis Child. Published Online First: 12 September 2007. doi:10.1136/adc.2007.115980
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health

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Papers

Infant HIV infection despite ‘universal’ antenatal testing

Siske S Struik 1, Gareth Tudor-Williams 2, Graham D Taylor 2, Simon D Portsmouth 1, Caroline J Foster 2, Clare Walsh 1, Christina Hanley 1, Sam Walters 1, John H Smith 1 and Hermione Lyall 1*

1 St Mary's NHS Trust, United Kingdom
2 Imperial College of Medicine, London, United Kingdom

* To whom correspondence should be addressed. E-mail: hermione.lyall{at}st-marys.nhs.uk.

Accepted 30 August 2007


*   Abstract

Objectives:To review the causes of vertically transmitted HIV since the introduction of universal offer and recommendation of first trimester HIV testing in the UK.

Design:Retrospective case note review.

Setting:A tertiary referral hospital with a PICU in London providing family centred care for HIV.

Subjects:All 25 infants diagnosed with HIV between 1 January 2001 and 31 December 2005.

Main outcome measures:Antenatal HIV testing, clinical presentation and outcome.

Results:Twenty-one of the 25 cases received antenatal care in the UK. Twelve mothers had not had an antenatal HIV test, four were diagnosed antenatally, whilst five had had a negative HIV test on antenatal booking, implying seroconversion during pregnancy. When mothers had not been diagnosed antenatally, infants presented with severe infections, which were fatal in 6 cases. The majority (65%) have long term neurological sequelae.

Conclusion:HIV seroconversion in pregnancy is an important cause of infant HIV in the UK.


Keywords: HIV, paediatric, pregnancy, seroconversion, vertical transmission




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