Thanks to access to antiretroviral treatment (ART), HIV- vertical transmission (VT) has dramatically decreased in the last years in Spain, and is situated today below 1%.The aim of this study was to describe the clinical and epidemiological features related with VT.
Retrospective, descriptive study (2014-2017) including all newborns to HIV infected mothers in a tertiary hospital in Spain. Epidemiological and clinical data related to the mother and newborn were recorded.
40 neonates were included, 92.5% born to mothers diagnosed with HIV before pregnancy. Median CD4-T-cell at delivery was 650,5/mm3 (IQR: 177-1700) and HIV-viral load: undetectable 32/40, if detectable, median 258 copies/mm3 (IQR: 37-486). CDC-2014 mother’s stage was: A1 (10%), A2 (35%), A3 (7,5%), B2 (7,5%), B3 (2,5%), C3 (20%), no data (12,5%). All women received treatment along pregnancy: 2 NRTIs + 1 NNRTIs (37%), 2 NRTIs + 1 PIs (45%), 2 NRTIs + 1 II (10%), other schemes (8%). The most commonly used regimen was Tenofovir-disoproxil-Fumarate+Emtricitabine+Rilpivirine (25%). 81,5% received Tenofovir as NRTI. 6/40 mothers received Raltegravir during the last weeks of pregnancy. The delivery was eutocic in 57.5%, and all cases received Zidovudine intrapartum. Median gestational age was 38.5 weeks (IQR: 32.8-40.3). All newborns were given prophylaxis for 28 days: zidovudine alone 80% and triple therapy (AZT+3TC+NVP) 20%. No newborn was breastfeeded. All children were follow up, and no cases of VT were documented.
There were no cases of vertical transmission of HIV between 2014 and 2017 in our hospital. Most women knew her HIV-status and received treatment before pregnancy. During pregnancy, most regimens are based on Tenofovir, with an increase in the use on integrase inhibitors, specially to achieve viral suppression before delivery.