Low detection rate of HIV infection in pregnant women has not changed in Britain

HIV among pregnant women has assumed greater importance because zidovudine substantially reduces the risk of mother to child transmission of HIV. In the first national report of HIV in pregnancy in the UK, Nicoll et al (page 253) report on nine years of data. HIV infections in London women have risen sixfold since 1988 and, although levels are lower elsewhere, over a third of births to infected women occur outside London. The most worrying finding is that the proportion of infections diagnosed antenatally has not increased: in 1996 only 15% were detected, so many preventable HIV infections are occurring in children.

Richardson and Sharland confirm these findings in their south west London HIV clinic (p 271). They compared 24 children born before 1992 (when guidelines on antenatal testing were introduced) with 24 born after 1992. More post-1992 children were born in London (17 v 5), but the mode of presentation and disease at diagnosis were similar in both groups: the mothers' HIV infection had been diagnosed antenatally in only 1 (6%) of the London born children.


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