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Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy

Published online by Cambridge University Press:  02 March 2006

M. FLORIDIA ,
M. RAVIZZA ,
E. TAMBURRINI ,
G. ANZIDEI ,
C. TIBALDI ,
A. MACCABRUNI ,
G. GUARALDI ,
S. ALBERICO ,
A. VIMERCATI  and
A. DEGLI ANTONI
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M. FLORIDIA
Affiliation:
Istituto Superiore di Sanità (ISS), Department of Drug Evaluation and Research, Rome, Italy
M. RAVIZZA
Affiliation:
Department of Obstetrics and Gynaecology, University of Milan, and S. Paolo Hospital, Milan, Italy
E. TAMBURRINI
Affiliation:
Università Cattolica del Sacro Cuore, Rome, Italy
G. ANZIDEI
Affiliation:
INMI L. Spallanzani, Rome, Italy
C. TIBALDI
Affiliation:
Department of Obstetrics and Gynaecology, University of Turin, and A.O. OIRM S. Anna, Turin, Italy
A. MACCABRUNI
Affiliation:
IRCCS ‘S. Matteo’, Pavia, Italy
G. GUARALDI
Affiliation:
Department of Medical Specialities, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy
S. ALBERICO
Affiliation:
Department of Obstetrics and Gynaecology, Policlinic Hospital, Trieste, Italy
A. VIMERCATI
Affiliation:
Department of Obstetrics and Gynaecology, University of Bari, and Policlinic Hospital, Bari, Italy
A. DEGLI ANTONI
Affiliation:
Azienda Ospedaliera di Parma, Italy
E. FERRAZZI
Affiliation:
Department of Obstetrics and Gynaecology, University of Milan, and Sacco Hospital, Milan, Italy
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Abstract

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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.

Type
Research Article
Information
Epidemiology & Infection , Volume 134 , Issue 5 , October 2006 , pp. 1120 - 1127
Copyright
2006 Cambridge University Press

Footnotes

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.