Backgrounds:

Nowadays HIV infection continues to be a major public health problem worldwide. Regarding to perinatal transmission, the introduction of preventive measures has achieved a marked decreased in transmission rate.Our aim was to describe the changes observed in Madrid Cohort of HIV-infected mother-infants pairs.

Methods

Multicenter, prospective, observational and cohort study of HIV-1 infected pregnant women and their infants during years 2000-2020. It collects information on clinical and epidemiologic characteristics of HIV-1 infected pregnant until delivery and their children in 9 hospitals. The results were classified in three periods: P1 between 2000-2006, P2 between 2007-2013 and P3 between 2014-2020.

Results:

A total of 1521 women living with HIV and 1548 newborns were included between years 2000-2020 (27 twin). 49.2% of births occurred in P1, 30.5% in P2 and 20.3% in P3.

Most of mothers (75.8%) in the first period were Spanish, with a predominance of women of foreign origin in P2 (62.8%) and P3 (70.5%).

The percentage of mothers with antiretroviral treatment before pregnancy was similar in P1 and P2 and increased significantly in the third period (p<0.01).

Maternal hepatitis C virus coinfection decreased dramatically from P1 (47%;n= 308) to P3 (5.4%;n=11).

The proportion of caesarean sections decreased over time: 66.2% (n=472) in P1, 54.9% (n=245) in P2 and 46.7% (n=141) in P3.

The percentage of preterm and low birth weight newborns showed a statistically significant decrease. Even though there were no statistically significant differences (p=0.154) a decrease in cases of perinatal infection was observed (Table 1).

Conclusions/Learning Points:

The epidemiological characteristics of pregnant women with HIV have changed over time in our setting. Perinatally HIV-infected children have decreased notably in recent years. Factors such as universal TARGA in pregnancy have contributed to improve it.