Background: Our objective was to evaluate the impact of antiretroviral therapy (ART) in the prevention of maternal-fetal HIV transmission in a population of HIV-infected pregnant women.
Patients and method: We studied prospectively all HIV-infected pregnant women attended in our hospital from January 1995 to December 2000. We offered treatment with zidovudine (ZDV) alone or in combination according to women's requirements.
Results: There were 98 mother-infant pairs and we studied 93 of them. The rate of vertical transmission was 1.4% when ART was started in pregnancy. Risk of HIV transmission was greater in mothers not being treated with ART during pregnancy (relative risk [RR]: 18; 95% confidence interval [CI]: 2.2-145.4), in mothers who only received ZDV at delivery and child vs those who received ART during pregnancy (RR: 16.4; 95% CI: 1.8-145.6) and in mothers who were active intravenous drug users (RR: 9.3; 95% CI: 2.2-38.5), with significant differences between vaginal delivery and caesarean section.
Conclusions: We observed a substantial benefit from ART, especially in the group of HIV-infected pregnant women who started treatment during pregnancy. Preventive interventions are needed.