HIV Pregnancy Dr med Annette E Haberl Universittsklinikum

HIV & Pregnancy Dr. med. Annette E. Haberl Universitätsklinikum Frankfurt am Main Infektionsambulanz

Frankfurt HIV-Cohort Patients May 2000 - May 2001 (n=2465) 1898 (77%) 567 (23%)

Frankfurt HIV-Cohort: Increase of Patients 19% 22% 24% 19% 24% 36%

Frankfurt HIV-Cohort: Pregnancies since January 1999 • all pregnancies: 78 • born children to date: 57 (1999: n=15; 2000: n=27; 2001: n=15) • missed abortions: 4 • interruption (medical reasons): 1 • ongoing pregnancies: 16 1. May 2001

Frankfurt HIV-Cohort: Characteristics of pregnant women Period of observation: January 1999 -May 2001 n= 78 patients 15 patients: IDU 28 patients: HES 35 patients: Pattern II

Pregnant Patients from Pattern-IIcountries (n=35) Countries of origin of the children fathers • 17/35 with a German husband/boyfriend • HIV-test 6/17 : 1/6 HIV-positive • 18/35 with a husband/boyfriend from the same mother-country • HIV-test 7/18 : 1/7 HIV-positive

Frankfurt HIV-Cohort: Prophylaxis of vertical transmission & HAART during pregnancy • high risk for transmission: 10 pts. • HAART: 24 pts. • prophylaxis : 23 pts. 24 23 10 Period of observation January 1999 -May 2001 n= 57 patients

Frankfurt HIV-Cohort: Prophylaxis of vertical transmission (n=23) • Combivir: • Retrovir: 21 2 patients

Frankfurt HIV-Cohort: Prophylaxis of vertical transmission high risk patients (n=10) • NRTI´s plus NNRTI (n=9) • NRTI´s (n=1)

Frankfurt HIV-Cohort: HAART of pregnant women (n=24) • NRTI´s plus PI • NRTI´s plus NNRTI 10 14 patients

HIV & pregnancy: Improvement in quality • German-Austrian Recommendations for the Treatment of HIV-positive Pregnant Women • Resistence testing • Pharmacokinetics • Documentation & publication

Frankfurt HIV-Cohort: Management of pregnant women from Pattern-II-countries • First positive HIV-test during pregnancy (all: 18/78; migrants: 12/35) • Communication problems • Social and/or political situation • Isolation • Lost-to-follow-up after delivery

Frankfurt HIV-Cohort: Management of pregnant IDU´s • • • Comorbidity Lack of compliance Ongoing use of illegal drugs Social problems Lost-to-follow-up after delivery

Frankfurt HIV-Cohort: Management of HIV & Pregnancy Results observational period I/1999 -V/2001; n=57 • no case of vertical transmission of HIV • 1 case of transmission of HCV (12 pregnant women coinfected with hepatitis C)

Management of HIV & Pregnancy Social work Political duty Medical care mother Medical care child

haberla@hivcenter. de