Background A policy for routine antenatal HIV testing was introduced in England in 1999, and commenced in Cambridge in 2002. Our antenatal population is generally of low risk for HIV and there is high uptake of screening.
Aim To describe lessons learned from our case series of HIV-positive mothers.
Methods Retrospective audit of maternal and infant records from the perinatal HIV clinic and recording of antenatal screening and postnatal outcome.
Results 30 cases of maternal HIV have been detected since screening began in 2002. Within this cohort 29 were detected on antenatal screening. One had, however, declined intrapartum screening and was diagnosed postnatally after her newborn infant was admitted with signs of sepsis. On taking a history, the mother was from a high-risk country for HIV and had declined antenatal testing due to ignorance of the therapeutic efficacy of perinatal therapy in reducing vertical HIV transmission. She agreed to testing postnatally after appropriate counselling.
Conclusion Antenatal HIV testing of all pregnant women is clearly an extremely effective medical intervention, reducing the vertical transmission of HIV to at-risk infants. This case series highlights that women who decline antenatal testing should be referred for specialist counselling as indicated by British HIV Association (BHIVA) guidelines. Ascertainment of HIV screening is an essential part of neonatal history taking even in a population of overall low-risk patients.