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Multicenter Study
. 2022 Dec 1;91(4):373-380.
doi: 10.1097/QAI.0000000000003070. Epub 2022 Oct 10.

Pregnancy Outcomes Among Perinatally HIV-Infected Women in Spain

Javier Nogueira López  1 , Luis Prieto-Tato  2 , Luis Escosa-García  3   4 , José I Bernardino  5   6 , Eloy Muñoz  7 , Cristina Díez  8   6 , Itzíar Carrasco  9   4 , Pablo Ryan  10   11   4 , Sara Guillén-Martín  12 , José Tomás Ramos-Amador  13   11   4 , María Luisa Navarro  11   14   4 , Africa Holguín  15 , Talía Sainz  3   16   4 ; CoRISpe Group
Affiliations
Multicenter Study

Pregnancy Outcomes Among Perinatally HIV-Infected Women in Spain

Javier Nogueira López et al. J Acquir Immune Defic Syndr. .

Abstract

Background: An increasing number of women living with perinatally acquired HIV are reaching adulthood and becoming pregnant. Achieving viral suppression is challenging in this population frequently exposed to numerous antiretroviral regimens. This study describes the long-term outcomes of pregnant women living with perinatally acquired HIV in Spain.

Methods: Descriptive, retrospective, multicenter study of the women living with perinatally acquired HIV who gave birth between January 2000 and December 2019 in Madrid. Epidemiological, clinical, and HIV-related data were collected from the first delivery to the end of the study period, including antiretroviral therapy, prevention strategies, and outcomes.

Results: Sixty-three live births in 33 women were included. The mean number of pregnancies per women was 1.9 (range: 1-6). At first delivery, women's median age was 20 years (interquartile range: 18-23), 11 (33.3%) had been previously diagnosed with AIDS and 6 (18%) with mental health disorders. Forty percent became pregnant unsuppressed, whereas 81% achieved viral suppression at delivery. Treatment interruptions were common after delivery, as were losses to follow-up, with no positive effect of pregnancy on retention to care or the immune virological situation. Five women (15%) experienced a new AIDS event, and there were 2 deaths (6%) during follow-up. There was 1 case of mother-to-child transmission in a nonadherent woman in whom preventive measures could not be implemented.

Conclusions: Pregnancy in this unique population of women living with perinatally acquired HIV poses particular challenges. Specific strategies, including a multidisciplinary approach, are needed to minimize perinatal transmission risks and improve outcomes during the postpartum period.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
Individual trajectories for VL in first and subsequent pregnancies in multiparous women.
FIGURE 2.
FIGURE 2.
Number of pregnancies in which women were retained in care, undergoing antiretroviral therapy, and virologically suppressed at conception, during pregnancy, and over the postpartum period. *Eleven of 43 had a subsequent pregnancy.
See this image and copyright information in PMC

References

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