Motherhood in HIV+ women infected in early childhood
© Dollfus et al; licensee BioMed Central Ltd. 2009
Published: 22 July 2009
As HIV infected girls enter adolescence and adulthood, the ability to become a mother is a question of outmost importance.
Due to major advances in treatment efficacy and MTCT strategies, a growing number of adolescents and young adults are facing the reality of motherhood. We wish to describe our experience of this relatively recent issue.
Methods and patients
Patients are all identified mother-infant pairs followed in a paediatric care reference center specialized in HIV where the mothers have been cared for as a child with HIV and their babies in the context of PTME follow-up.
Data used are those systematically collected in the patients' medical files, with treatment and evaluation following national guidelines.
8 mothers had 18 pregnancies, resulting in a total of 9 live – born children.
6 of them experienced one or more elective abortions (1–3); in only one instance the decision was based on medical reason (patient conceving under Efavirenz treatment).
3 mothers were younger than 18 at their first pregnancy although the median age was 19.5 years (16;28). The median age at child birth as 21.5 years (17;31).
6/8 mothers had been infected through blood transfusion in their early childhood; 2/8 by vertical transmission. 7/8 fathers were informed of maternal status.
All mothers took ARV treatment during pregnancy. In all cases maternal viral load close to delivery was < 500 c/ml.
Six women delivered vaginally, although 3 underwent caesarean section.
Children were born between 1996 and 2008; all of them benefited of post natal antiretroviral prophylaxis (6 AZT, 1 AZT+3TC, 1 Lopinavir/Ritonavir).
All children are HIV-uninfected (minimum 3 DNA PCR) and healthy, with a current median follow-up of 2 years (4 months; 5 years).
These adolescent females who had been diagnosed as HIV-infected during childhood demonstrated a strong willingness to be pregnant. They delivered uninfected and healthy children, defying predictions that were made at the time of their own diagnosis. Long-term medical and psychological support remains needed for these young mothers.
This article is published under license to BioMed Central Ltd.