2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Little et al.Pediatr Infect Dis J2017; 36:66

Slide7of42FromJRAnderson,MDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

Change in MTCT in Resource-Rich Countries

UK (2012-2014:0.3% US (2016est): 0.9%

40

CombinationARVEra

ZDV Era

30

24.5

20

Transmission (%)

10

7.6

5.0

3.3

2.0

1.5

1.2

0.5

0

1993: WITS

1994: PACTG 076

1997: PACTG 185

1999: WITS

2001: PACTG 247

2002: PACTG 316

2003: WITS

2011: UK

Courtesy LynneMofenson

Slide8of42FromJRAnderson,MDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

Perinatal Cascade: 2005-2014

HIV-Exposed/Uninfected

HIV-Infected

No/inadequate prenatal care

21-31%

44-58% (noPNC11%)

PrenatalARVs

86-93%

40-52%

Intrapartum ARVs

80-95%

50-62%

Elective C-section

40%

29-40%

Neonatal ARVs

93-99%

67-92%

Breastfed

1.5%

10%

Maternal HIVdxbefore pregnancy 75-82%

~50%

Maternal HIVdxat/afterdelivery <10%

21-29%

Overall prenatal HIV testing rate hasnot exceeded 76% since 2006

7-18% infants with perinatal HIVborn towomen with acuteHIV inpregnancy

Nesheim et al.Pediatr Infect Dis J2019;38:611

Slide9of42FromJRAnderson,MDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.