Methods
Maternal and neonatal de-identified data was obtained from the South Carolina Department of Health and Environmental Control (DHEC) for all known HIV-infected women delivering in South Carolina from 2004-2014. Statistical analysis was performed using SAS 9.4 (Cary, NC). We compared maternal HIV RNA viral load,CD4 cell counts and pregnancy outcomes between women with PHIV versus nPHIV women. Continuous variables were compared with Student’s t-test and Wilcoxon Rank Sum Tests. Categorical variables were compared using χ2 test and Fisher’s exact test.
Results
We identified 26 mothers with PHIV and 859 mother with nPHIV. PHIV mothers were more likely to have been diagnosed with HIV in a state other than South Carolina (19% vs 7%, p= 0.03) and use combination anti-retroviral therapy (cART) containing a protease inhibitor (85% vs 44%, p<0.0001) or alternative ART, including integrase inhibitors, CCR5 receptor antagonists, and fusion inhibitors (15% vs 2%, p=0.004). PHIV were less likely to have antepartum cART that included AZT (38% vs 74%, p< 0.0001), deliver preterm (<37 weeks gestation) (4% vs 23%, p=0.03), and deliver a low birthweight (< 2500 grams) infant (8% vs 27%, p=0.02). PHIV women had no cases of neonatal death (0 vs 2%, p=1.0), twin delivery (0 vs 4%, p=0.6), nor perinatal HIV transmission to their infants (0 vs 1%, p=1.0). PHIV and nPHIV women had similar rates of HIV RNA viral load > 1000 copies prior to delivery (13% vs 20%, p=0.6) and undetectable HIV RNA viral load prior to delivery (44% vs 40%, p=0.7). Rates of cesarean delivery were similar between groups (56% vs 54%, p=0.8). The prevalence of HIV/AIDS (CD4 cell count < 200 cells/mm3) was similar in PHIV and nPHIV women (65% vs 49%, p=0.09).
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