Online Program

Early Antiretroviral Therapy & Neonatal HIV Staging

Tuesday, November 3, 2015

Joy Kane, MPH, HIV/STI Surveillance, Epidemiology, and Research, Chicago Department of Public Health, Chicago, IL
Divina Vargas, BA, Surveillance, Epidemiology & Research Section, Chicago Department of Public Health, Chicago, IL
Stephanie Townsell, MPH, Surveillance, Epidemiology & Research Section, Chicago Department of Public Health, Chicago, IL
Maxwell Hellmann, BA, Surveillance, Epidemiology & Research Section, Centers for Disease Control and Prevention, Chicago Department of Public Health, Chicago, IL
Nanette Benbow, MAS, HIV/STI Services Division, Chicago Department of Public Health, Chicago, IL
Antenatal and neonatal HIV antiretroviral therapy (ART) is recommended for prevention of vertical transmission of HIV and neonatal HIV/AIDS complications. HIV perinatal exposure cases have been monitored in Chicago since 1999, when the Institute of Medicine recommended HIV prenatal care, testing, and treatment.

Using the Enhanced HIV/AIDS Reporting System, demographic and health outcome data were extracted for infants diagnosed with HIV in Chicago from 2000-2014. HIV staging was evaluated using Fisher’s Exact.

There were 84 perinatally exposed HIV cases in Chicago from 2000-2014. Newborns’ race was 12% Hispanic, 82% Black, and 6% Multi-Racial. Of 57 neonates with documented ART history, 29 neonates’ mothers were given ART during labor and 28 were documented as not having received treatment. The race of ART recipients versus non-recipients did not vary significantly (p=0.75).

For initial diagnosis post-delivery, 29% of cases were pediatric AIDS and 71% were pediatric HIV. Compared to neonates without ART (pre/post-natally), receiving any early ART was correlated with a smaller proportion of AIDS cases (10% vs 38%), p=0.01.

Receiving pre/post-natal ART resulted in significantly fewer diagnoses of pediatric AIDS versus HIV (p<0.05). A limitation of using surveillance data was the lack of complete maternal health records.  In a previously CDC-sponsored project, “Enhanced Perinatal Surveillance” 387 perinatal exposures were identified and eight seroconverted (2005-2008, Chicago).

Resuming funding for expanded surveillance would allow for characterization of pregnant women with HIV. Such policy improvements could increase HIV perinatal transmission prevention, prenatal care, ART during delivery, and treatment of newborns.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe HIV perinatal cases from 2000-2014 in Chicago using data from the Enhanced HIV/AIDS Reporting System. Compare HIV versus AIDS diagnosis for infants who received ART. Discuss potential surveillance methods to better identify HIV perinatal cases.

Keyword(s): Surveillance, Women and HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal author on two publications focusing on HIV prevention strategies. I have been listed as an author for several manuscripts about immunology. My current position is an HIV epidemiologist in a public health department, which makes me qualified for the subject manner presented in the abstract. The abstract submitted is the summation of 15 years of data, which calls for more extensive research.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
City of Chicago Department of Public Health HIV Surveillance, Epidemiology & Research Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.