Mother-to-child-transmission (MTCT) of human immunodeficiency virus (HIV) in designated hospital in Hong Kong

Abstract

Background: Mother-To-Child-Transmission (MTCT) of Human Immunodeficiency Virus (HIV) infection in developed countries are by and large lowered to very low level by preventive and prophylactic measures including antenatal universal screening of HIV antibody in pregnant women, antiretroviral prophylaxis, elective caesarean sections and avoidance of breast feeding after birth. The exact MTCT rate after commencement of the above prophylactic measures in Hong Kong remains uncertain. Objective: To determine the MTCT rate of a designated hospital taking care of people living with HIV or Acquired Immunodeficiency Syndrome (AIDS) in Hong Kong and to study the potential side effects and toxicity of antiretroviral prophylaxis given in antenatal, intrapartum and postnatal period in newborns born from HIV infected mothers in the designated hospital. Methods: Retrospective descriptive study of all newborns born from HIV infected mothers during the period of 1st January 2002 to 31st December 2010 in the designated hospital was conducted. Results: Total 17 infants born from HIV infected mothers are identified. It consists of 31.5% of total number of infants born from HIV infected mothers in Hong Kong. Only 1 was diagnosed to have HIV infection at 4 months of age. Hence, the MTCT rate is 5.9% in the designated hospital. Serial haemoglobin (Hb) levels and liver function (LFT) at birth of all infants; lactate only when infants develop symptoms indicating neurologic involvement are recorded. Only the Hb levels at birth are moderately lower than normal which indicate mild transient marrow toxicity. Conclusions: The MTCT rate in a designated hospital in Hong Kong is approaching the rate in developed countries after commencement of various preventive and prophylactic measures for prevention of MTCT in HIV infected mothers. No significant persistent toxicity of antiretroviral prophylaxis exposure during antenatal, intrapartum and postnatal period in infants born from HIV infected mothers is identified. However, prolonged follow up for potential long term teratogenic and carcinogenic effect is still suggested for such exposure.