Abstract 952 Poster Session IV, Tuesday, 5/4 (poster 98)

We summarized perinatal infection rates in Northern California over a six-year period using population-based active surveillance of children born to women with human immunodeficiency virus type 1 (HIV-1) infection. Surveillance at six pediatric regional referral centers from 1990 through 1995 were evaluated and matched with regional HIV seroprevalence among childbearing women in those years. From these data, the number of HIV-infected women projected to give birth was determined as well as the number of infants born to HIV-infected women in the region during those years, and the number of infected infants was calculated. In total, 426 infants with HIV exposure were identified in the region from 1990 through 1995. The table depicts exposed and HIV-infected infants, both observed and expected, identified by surveillance in the region. Through 1995, maternal HIV seroprevalence of Bay Area women remained stable at 0.8 - 1.1 infections per 1000 women. The percentage of exposed infants identified at Bay Area clinics of those infants expected (based on seroprevalence rates) rose from 53% in 1990 to 75% in 1995. This trend may indicate that prenatal care and testing of the high-risk maternal population increased. The number of observed infected infants as a percentage of expected infected infants (based on 10%-25% transmission rates) yielded a range from 35% to 170%. From 1992-1995 we identified a number of infected infants which exceeded a 10% transmission rate, expected if all HIV-infected women in the region participated in the ACTG 076 regimen. The proportion of infants infected of those identified as exposed was 38% in 1990 vs. 19% in 1995. This significant drop could be due partly to actual reduction of transmission and partly to an enhanced ability to identify HIV+ childbearing women in a prenatal setting. (Table)

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Funded by the California Department of Health Services, Office of AIDS.