1 / 20

Perinatal HIV Case Series Reports for Births in 2005-2006

Perinatal HIV Case Series Reports for Births in 2005-2006. Presenter: Elvia Ledezma Texas Department of State Health Services. Overview of Infected Children, 2005-2006 . In Texas 558 HIV+ women delivered in 2005-2006 13 children are HIV+ 2005-5 infected 2006-8 infected

jess
Download Presentation

Perinatal HIV Case Series Reports for Births in 2005-2006

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Perinatal HIV Case Series Reports for Births in 2005-2006 Presenter: Elvia Ledezma Texas Department of State Health Services

  2. Overview of Infected Children, 2005-2006 • In Texas 558 HIV+ women delivered in 2005-2006 • 13 children are HIV+ • 2005-5 infected • 2006-8 infected • 2.3% of all births for this period are infected

  3. Infected children born to HIV positive women living outside of Houston

  4. Case #1 Demographics • Age 37; Single; Black/ Non-Hispanic; 4 previous pregnancies HIV/STD History • No STDs; + HIV test 14 years prior; AIDS one month after HIV diagnosis • Mode of Exposure-IV Drug Use Pregnancy • Limited Prenatal Care (1 to 2 visits) • No ART (non-compliant prior to pregnancy) Labor and Delivery • Receipt of ART • Elective C-Section (Viral Load-933,000 copies/mL ) • Toxicology Screen Positive for Cocaine (mother and infant) Birth History • Receipt of ART • 35 weeks gestation and 2075 grams in weight • No Breastfeeding Noted and Unknown if received PCP prophylaxis

  5. Case #2 Demographics • Age 19; Single; Black/ Non-Hispanic; 3 previous pregnancies HIV/STD History • No STDs; 1st + HIV test at delivery (EIA, WB); AIDS 7 months after delivery • Mode of Exposure- Heterosexual Contact Pregnancy • No Prenatal Care • No ART Labor and Delivery • No ART • C-section of Unk. Type • Toxicology Screen Positive for Cocaine (mother only) Birth History • Twins • Receipt of ART 4 days after delivery • 40 weeks gestation and 2329 grams in weight • Unknown if Breastfed or if received PCP prophylaxis

  6. Case #3 Demographics • Age 34; Single; Hispanic; No previous pregnancies HIV/STD History • STDs present at delivery; + HIV test 9 years prior; AIDS diagnosis at delivery • Mode of Exposure- Heterosexual Contact Pregnancy • No prenatal care reported • No ART Labor and Delivery • Receipt of ART • Elective C-Section • Toxicology Screen Positive for Cocaine (mother ) Birth History • Receipt of ART • 39 weeks gestation and 3585 grams in weight • Unknown if Breastfed or if received PCP prophylaxis

  7. Case #4 Demographics • Age 27; Single; Black/Non-Hispanic; No previous pregnancies HIV/STD History • STDs present at delivery; + HIV test 2 years prior • Mode of Exposure- Heterosexual Contact Pregnancy • No prenatal care reported • No ART • CD4 Count (156) and Viral Load (1800 copies/ml) Labor and Delivery • Receipt of ART • Elective C-Section • Negative Toxicology Screen Birth History • Receipt of ART • 35 weeks gestation and 2315 grams in weight • No breastfeeding and unknown if received PCP prophylaxis

  8. Case #5 Demographics • Age 28; Single; White/Non-Hispanic; 1 previous pregnancy HIV/STD History • No STDs; -HIV antibody test 6 months prior to deliv.; + HIV test 2 days after (PCR, EIA, WB) • Mode of Exposure- Not specified Pregnancy • Prenatal began in 2nd Trimester (10 visits) • No ART Labor and Delivery • No ART • Vaginal Delivery • Indication of drug use but no toxicology screen done Birth History • Receipt of ART (2 days after birth) • 39 weeks gestation and 3190 grams in weight • No breastfeeding and unknown if received PCP prophylaxis

  9. Case #6 Demographics • Age 30; Married; Black/Non-Hispanic; 3 previous births HIV/STD History • No STDs; + HIV 2 months prior to delivery • Mode of Exposure- Not specified Pregnancy • Prenatal began in 3rd Trimester (1 visit) • No ART Labor and Delivery • Vaginal Delivery prior to arrival at the hospital • No ART • Positive Toxicology Screen (mother and child) • Viral Load (34,500 copies/ml)-after delivery Birth History • Receipt of ART • 40 weeks gestation and 2627 grams in weight • No breastfeeding and unknown if received PCP prophylaxis

  10. Case #7 Demographics • Age 26; Single; Black/Non-Hispanic; Unknown pregnancy history HIV/STD History • No STDs; + HIV test 6 years prior; AIDS diagnosis during pregnancy • Mode of Exposure- Heterosexual Contact Pregnancy • Prenatal began in 2rd Trimester (3 visits) • Receipt of ART • CD4 (125) and Viral Load (49,800 copies/ml) Labor and Delivery • Vaginal Delivery • Receipt of ART • Positive Toxicology Screen (mother and child) Birth History • Receipt of ART • 35 weeks gestation and 2070 grams in weight • No breastfeeding and unknown if received PCP prophylaxis

  11. Case #8 Demographics • Age 36; Single; White/Hispanic; 1 previous birth HIV/STD History • No STDs; + HIV test at delivery (EIA and WB) • Mode of Exposure- None specified Pregnancy • No prenatal care • No ART Labor and Delivery • Vaginal Delivery • No ART • No indication of substance use and no toxicology screen • Viral Load (750,000 copies/ml) Birth History • Receipt of ART • 38 weeks gestation and 3096 grams in weight • No breastfeeding and unknown if received PCP prophylaxis

  12. Two Cases with Unknown Mode of Exposure • Due to limited information on the mother the children's mode of exposure is classified as “Pediatric Other/Undetermined” • Unknown locations of birth (Potential births outside of the U.S.) • Mothers are of Hispanic decent • Both children were adopted and are living in Texas

  13. Demographics of HIV+ Women Delivering an Infected Child, 2005-2006 • Age Range: 62.5% of women were 25 to 34 years of age • Marital Status: 87.5% were single • Race/Ethnicity: 62.5% Black; 25% Hispanic; 12.5% White • More than half had a previous pregnancy • Average of 2 pregnancies for these 5 women

  14. HIV/STD History of Women Delivering an Infected Child, 2005-2006 • STD at Delivery • 25% record of an infection • Mode of Exposure • 25% IV • 50% Heterosexual Contact

  15. HIV/STD History of Women Delivering an Infected Child, 2005-2006 • Timing of HIV Test • 50% prior to delivery (Avg-8 years prior to delivery) • 12.5% during pregnancy • 25% at delivery • 12.5% after delivery • AIDS Diagnosis • 25% diagnosed during pregnancy or at delivery • 25% diagnosed after delivery

  16. Overview of Women Delivering an Infected Child, 2005-2006 • Only half of women received prenatal care • Limited prenatal care visits (Range 1-10) • 87.5% did not receive ART during pregnancy • Only 50% received ART during delivery

  17. Overview of Women Delivering an Infected Child, 2005-2006 • 100% received ART neonatally • 25% of children unknown if breastfed • 62.5% had a positive toxicology screen

  18. Conclusion • EPSTexas Perinatal StatsCase Reports • Missed opportunity challenges • Lack of prenatal care • Lack of ART during pregnancy • Timing of HIV test results • Assure medical information is available • Prevention recommendations

  19. Discussion/Comments

  20. Contact Information • Elvia Ledezma, MPH Epidemiologist Texas Department of State Health Services (512)-533-2045 elvia.ledezma@dshs.state.tx.us

More Related