Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy 1
We analysed the characteristics of the pregnancies with a previously undetected HIV infection in a national observational study of pregnant women with HIV in Italy. In a total of 443 pregnancies with available date of HIV diagnosis, 118 were characterized by a previously undetected HIV infection (26·6%, 95% CI 22·5–30·8). The following factors were independently associated with this occurrence in a multivariate analysis (adjusted odds ratios; 95% CIs): foreign nationality (5·1, 2·8–9·3); no pre-conception counselling (35·9, 4·8–266·1); first pregnancy (2·1, 1·2–4·0); asymptomatic status (6·8, 1·5–30·6). Women with previously undetected infection started antiretroviral treatment significantly later during pregnancy (P<0·001). Missed diagnosis was responsible for one case of transmission. A high rate of previously undetected HIV infection was observed. This suggests a good HIV detection during pregnancy, but also the need to reinforce HIV testing strategies among women of childbearing age. We identified some determinants which may be considered for intervention measures.(Accepted January 4 2006)
(Published Online March 2 2006)
c1 Department of Drug Evaluation and Research, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. (Email: email@example.com)
1 This paper was presented in part at the 17th ANLAIDS National Conference on AIDS, Rome, 28–30 November 2003; and at the World Conference ‘Securing treatment and care for people living with HIV. Low-income countries: where are we now?’, Florence, 21–24 January 2004.
2 for The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy. The Group is listed in the Appendix.