Infection
Volume 47, Issue 5, 2019, Pages 847-852

Impact of refugee influx on the epidemiology of late-presenting HIV-infected pregnant women and mother-to-child transmission: comparing a southern and northern medical centre in Germany (Article)

Singer K. , Schulze-Sturm U. , Alba-Alejandre I. , Hollwitz B. , Nguyen T.T.T. , Sollinger F. , Eberle J. , Hübner J. , Kobbe R. , Genzel-Boroviczény O. , von Both U.*
  • a Division of Neonatology Campus Innenstadt, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany, Division of Paediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
  • b Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • c Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
  • d Department of Obstetrics and Prenatal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • e Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • f Division of Paediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
  • g Division of Virology, National Reference Center for Retroviruses, Max von Pettenkofer-Institute for Hygiene and Clinical Microbiology, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
  • h Division of Paediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
  • i Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • j Division of Neonatology Campus Innenstadt, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
  • k Division of Paediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany

Abstract

Purpose: Due to early antenatal screening and treatment, HIV mother-to-child transmission (MTCT) rarely occurs in Germany. The study aimed to investigate the impact on prevalence of HIV infection in the antenatal population and the incidence of late-presenting HIV-infected mothers attributable to increased numbers of refugees. Methods: Retrospective analysis and comparison were performed for all deliveries in HIV-infected pregnant women presenting to medical care in Munich (southern Germany) and Hamburg (northern Germany) covering two time periods, A (2010–2012) and B (2013–2015). Results: In Munich, deliveries in HIV-infected pregnant women increased 1.6-fold from period A (n = 50) to B (n = 79) with late-presenting cases rising significantly from 2% (1/50) in period A to 13% (10/79) in B. In contrast, late-presenting cases in Hamburg decreased from 14% (14/100) in period A to 7% (7/107) in B, while the total number of HIV-infected women giving birth remained stable. From 2010 to 2015, one late-presenting pregnant woman transmitted HIV in Munich by presumed in utero mode of infection (case reviewed here), while no MTCT occurred in Hamburg. Conclusions: HIV infections diagnosed late in pregnancy and leading to delayed ART initiation are rising in Munich compared to Hamburg. Antenatal care of HIV-infected pregnant women in Munich appears to have been more affected by the recent refugee influx than Hamburg. Our study highlights the importance of screening all pregnant women for HIV early in pregnancy and providing timely health care access for pregnant refugees and asylum seekers to effectively prevent MTCT in Germany. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Author Keywords

Late presenting MTCT Mother-to-child transmission Refugees HIV

Index Keywords

blood sampling Germany Africa south of the Sahara refugee Human immunodeficiency virus infection ampicillin human Human immunodeficiency virus infected patient comparative study epidemiological data Young Adult case report female Infant newborn clinical article latent syphilis Syphilis benzathine penicillin raltegravir abacavir mother to child transmission Article disease transmission obstetric delivery newborn sepsis emtricitabine tenofovir penicillin derivative adult cefotaxime lamivudine virus load nevirapine zidovudine pregnant woman vertical transmission retrospective study sepsis medical care mother child relation
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85067833995&doi=10.1007%2fs15010-019-01332-3&partnerID=40&md5=bd1a89dfbefe13ce04424319932e751f
DOI: 10.1007/s15010-019-01332-3
ISSN: 03008126
Cited by: 1
Original Language: English