Aims To audit the knowledge of HIV status of children of HIV-positive women registered at an adult HIV clinic.
Methods A retrospective case note review of all HIV-positive women registered at an adult HIV clinic.
Results 1534 patients were seen in the year March 2008–February 2009. 178 (11.6%) were women and 176 (99%) of case notes were accessed. Most were from African countries (55%). Median age was 36 (range 18–77). 123 (69%) women had 245 offspring in total. 85 (48%) women had 138 (56%) offspring in the UK. The age range of the offspring was 1–32 years. 91/245 (37%) of offspring in total had been tested, of whom 11 (12%) were positive and 80 (88%) negative. Of the 138 offspring in the UK, 84 (61%) had been tested. 41 (30%) had an unknown test status of whom 29/41were currently under the age of 18. For 13 (9%) of the offspring there had been an active decision not to test mainly due to them being asymptomatic. Six of these 13 asymptomatic offspring were children currently aged <18 years. There were 32 offspring living in known worldwide locations outside the UK. The remaining offspring were in unknown locations (and have possibly arrived in the UK since the first presentation of their mother).
Conclusions This audit has identified a group of 35 (29 unknown test result and 6 actively not tested) children in one area of the UK at risk of undiagnosed HIV infection. This may be an underestimation due to children arriving to join parents. To address this locally all patients will be asked about children at each visit and an alert system for the need to test children will be incorporated into the existing patient database. A deferral period for testing of 6 months has been agreed. Close liaison between adult and paediatric HIV services should continue to be built up throughout the UK in order to avoid missing HIV-positive children.