1 / 14

Margaret Lampe, RN, MPH Division of HIV/AIDS Prevention, CDC

Diagnosing HIV infection during pregnancy: Detecting acute infection and the role of the proposed new algorithm November 18, 2013. Margaret Lampe, RN, MPH Division of HIV/AIDS Prevention, CDC. National Center for HIV/AIDS, Viral Hepatitis, TB & STD Prevention. Division of HIV/AIDS Prevention.

elwyn
Download Presentation

Margaret Lampe, RN, MPH Division of HIV/AIDS Prevention, CDC

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. Diagnosing HIV infection during pregnancy: Detecting acute infection and the role of the proposed new algorithmNovember 18, 2013 Margaret Lampe, RN, MPH Division of HIV/AIDS Prevention, CDC National Center for HIV/AIDS, Viral Hepatitis, TB & STD Prevention • Division of HIV/AIDS Prevention

  2. Perinatal HIV Prevention Cascade

  3. Current Testing Recommendations in Pregnancy • Universal opt-out HIV testing of all pregnant women • 3rd trimester testing recommended • In 22 jurisdictions: • AL, CT, DE, DC, FL, GA, IL, LA, MD, MA, MS, NV, NJ, NY, NC, PA ,PR, RI, SC, TN, TX, and VA • For women at high risk of acquiring HIV infection • Women who have signs or symptoms of acute (early) HIV infection

  4. Current Testing Recommendations in Pregnancy (cont.) • Any woman with undocumented HIV status at the time of labor should be screened with a rapid HIV test • When a woman's HIV status is still unknown at the time of delivery, she should be screened immediately postpartum with a rapid HIV test unless she declines • When the mother's HIV status is unknown postpartum, rapid testing of the newborn as soon as possible after birth is recommended

  5. Data Review

  6. Prenatal HIV testing rates 1999-20011 20032 20053 20064 20105 91% 49-95% 78% 74% 75.9% 1EPS; 2Taylor, RTI chart review; 3MIRIAD; 4Fitz Harris, medical record review; 5CROI 2013, MarketScan Commercial Claims data 2008-2010

  7. Timing of Maternal HIV Diagnosis* *EPS data

  8. Acute HIV Infection During Pregnancy and Mother-to-Child HIV Transmission:  Data from Enhanced Perinatal Surveillance, United States, 2005-2010

  9. Methods • HIV-infected women who delivered live infants 2005-2010 • EPS data linked with National HIV Surveillance System data through June 2011 • Determined number of DP and PTP seroconverters • DP seroconverters had negative HIV test during pregnancy and positive HIV test during pregnancy, labor/delivery or 90 days after infant date of birth • PTP seroconverters diagnosed prior to pregnancy • Determined proportion of perinatal infection which occur in the context of maternal primary infections • Calculated MCT among DP and PTP seroconverters • Estimated annual percent change used to examine trends in percentages of DP and PTP seroconverters and MCT in seroconvertergroups

  10. HIV Seroconversions During Pregnancy and Prior-to-Pregnancy, EPS, 2005-2010 *Estimated Annual Percent Change p<0.0001

  11. 28-36 Weeks 36+ Weeks

  12. Perinatal HIV Transmission Among DP and PTP Seroconverting Women, EPS, 2005-2010

  13. Testing during labor and delivery • Discussion: • How will the proposed new algorithm be beneficial? • Will it pose challenges? • What is already happening in New Jersey?

More Related