Select Committee on Health Written Evidence


Memorandum by the National Study of HIV in Pregnancy and Childhood (HA 29)


  Surveillance of obstetric and paediatric HIV in the UK is carried out through the National Study of HIV in Pregnancy and Childhood (NSHPC) at the Institute of Child Health, University College, London. The NSHPC provides the paediatric data for the overall national surveillance of HIV: summary data are forwarded to the Health Protection Agency Centre for Infections and Health Protection Scotland four times a year for integration with adult data.

  1.  Anonymised demographic, laboratory and clinical information on pregnant women is available; this includes country of origin, timing of maternal diagnosis, uptake of interventions to reduce the risk of mother to child transmission of infection (antiretroviral therapy and mode of delivery), outcome of pregnancy and the subsequent infection status of the child.

  2.  In the UK it is estimated that about 25% of HIV positive women who remain undiagnosed at delivery will transmit infection to their baby. Antiretroviral therapy in pregnancy, caesarean section delivery, and avoiding breast feeding substantially reduce the risk of transmission, and most diagnosed women take up these interventions. As a result, less than 2% of infants born to diagnosed women in the UK are themselves infected.

  3.  Since the introduction of the routine offer and recommendation of HIV testing to all pregnant women as an integral part of antenatal care (in England in 2000, and subsequently elsewhere in the UK), a steadily increasing proportion of HIV infected pregnant women have been diagnosed before delivery. In 2003 nearly 900 HIV infected women gave birth in the UK, of whom over 90% were diagnosed before delivery. Nevertheless, about 170 infected children are believed to have been born in the UK between 2000 and 2003, 80% of them to women who were undiagnosed at the time of their child's birth. About two-thirds of these infected children have been diagnosed and reported to the NSHPC so far, including 13 who have died.

  4.  A majority of HIV infected pregnant women giving birth in the UK were themselves born overseas. Any developments which discourage women from accessing antenatal care, or restrict their access to interventions, could result in avoidable transmission of HIV from mother to baby.

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