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Infant HIV infection despite ‘universal’ antenatal testing
  1. Siske S Struik (siskestruik{at}hotmail.co.uk)
  1. St Mary's NHS Trust, United Kingdom
    1. Gareth Tudor-Williams (g.tudor-williams{at}imperial.ac.uk)
    1. Imperial College of Medicine, London, United Kingdom
      1. Graham D Taylor (g.p.taylor{at}imperial.ac.uk)
      1. Imperial College of Medicine, London, United Kingdom
        1. Simon D Portsmouth (simon.portsmouth{at}st-marys.nhs.uk)
        1. St Mary's NHS Trust, United Kingdom
          1. Caroline J Foster (drcarolinefoster{at}btinternet.com)
          1. Imperial College of Medicine, London, United Kingdom
            1. Clare Walsh (clare.walsh{at}st-marys.nhs.uk)
            1. St Mary's NHS Trust, United Kingdom
              1. Christina Hanley (christina.hanley{at}st-marys.nhs.uk)
              1. St Mary's NHS Trust, United Kingdom
                1. Sam Walters (s.walters{at}imperial.ac.uk)
                1. St Mary's NHS Trust, United Kingdom
                  1. John H Smith (john.smith{at}st-marys.nhs.uk)
                  1. St Mary's NHS Trust, United Kingdom
                    1. Hermione Lyall (hermione.lyall{at}st-marys.nhs.uk)
                    1. St Mary's NHS Trust, United Kingdom

                      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.

                      • HIV
                      • paediatric
                      • pregnancy
                      • seroconversion
                      • vertical transmission

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