Carlos del Rio, MD reviewing Taylor AW et al. JAMA Pediatr 2017 Mar 20.

Complete elimination of perinatal HIV transmission is possible, yet remains elusive because of missed opportunities.

Before 1994, risk for perinatal HIV transmission in the U.S. was about 25%. Now, with routine HIV testing of pregnant women and combination antiretroviral therapy for those found to be infected, risk for transmission approaches zero — yet cases of perinatal HIV infection continue to be diagnosed. To shed light on this apparent contradiction, CDC investigators reviewed data from the National HIV Surveillance System through 2015 and examined perinatal HIV transmission events that occurred between 2002 and 2013.

The number of perinatal HIV transmissions fell from 216 in 2002 to 69 in 2013 (i.e., from 5.4 to 1.8 per 100,000 live births). Among infected mothers, 63.0% were black and 18.3% were Hispanic or Latino. The proportion of women with no reported perinatal care rose from 9.7% (in 2002–2005) to 16.7% (in 2010–2013). Overall, almost 70% of cases occurred in 10 states and almost 40% in 5 southern states. During the most recent 4-year period (2010–2013), 36.2% of cases occurred in 3 states (Florida, 48; Texas, 44; Georgia, 42).

CITATION(S):

Taylor AW et al. Estimating perinatal HIV infection among infants born in the United States, 2002-2013. JAMA Pediatr 2017 Mar 20; [e-pub].

JWatch