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The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy
- Source :
- European Journal of Public Health, 21(5), 632-7. Oxford University Press, European Journal of Public Health, 21, 5, pp. 632-7, European journal of public health, 21(5), 632-637. Oxford University Press, European Journal of Public Health, 21(5), 632-637. Oxford University Press, European Journal of Public Health, 21, 632-7
- Publication Year :
- 2011
-
Abstract
- Contains fulltext : 96418.pdf (Publisher’s version ) (Closed access) BACKGROUND: In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in terms of detection of new cases of HIV and vertical transmission. METHODS: HIV-infected pregnant women were identified retrospectively from the Dutch HIV cohort ATHENA January 2000 to January 2008. Apart from demographic, virological and immunological data, the date of HIV infection in relation to the index pregnancy was established. Separately, all infants diagnosed with HIV born following implementation of the screening program were identified by a questionnaire via the paediatric HIV centres. RESULTS: 162/481 (33.7%) HIV-positive pregnant women were diagnosed with HIV before 2004 and 172/214 (80.3%) after January 2004. Multivariate analysis showed an 8-fold (95% confidence interval 5.47-11.87) increase in the odds of HIV detection during pregnancy after the national introduction of the opt-out strategy. Still, three children born during a 5-year period after July 2004 were infected due to de novo infection in pregnancy. CONCLUSIONS: Implementation of a nation-wide screening strategy based upon non-selective opt-out screening followed by effective PMTCT appeared to detect more HIV-infected women for the first time in pregnancy and to reduce vertical transmission of HIV substantially. Nonetheless, still few children are infected because of maternal infection after the first trimester. We propose the introduction of partner screening on HIV as part of the antenatal screening strategy.
- Subjects :
- Adult
medicine.medical_specialty
Multivariate analysis
mother-to-child-transmission
Infectious Disease Transmission
Antiretroviral Therapy
HIV Infections
Auto-immunity, transplantation and immunotherapy [N4i 4]
Cohort Studies
Young Adult
SDG 3 - Good Health and Well-being
Pregnancy
Antiretroviral Therapy, Highly Active
Medicine
Vertical
Humans
Mass Screening
Highly Active
antenatal screening
Young adult
Pregnancy Complications, Infectious
Mass screening
Netherlands
Retrospective Studies
business.industry
Transmission (medicine)
Obstetrics
Public Health, Environmental and Occupational Health
Infectious
Infant, Newborn
Infant
HIV
virus diseases
Retrospective cohort study
medicine.disease
Newborn
Infectious Disease Transmission, Vertical
Pregnancy Complications
Human Reproduction [NCEBP 12]
Immunology
Cohort
Female
business
Cohort study
Subjects
Details
- ISSN :
- 11011262
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- European Journal of Public Health
- Accession number :
- edsair.doi.dedup.....d3316cbae2eda50e76faafca1325a349