International Journal of STD & AIDS > Volume 20, Number 7 > Pp. 473-476

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Original research articles

Prevention of human immunodeficiency virus mother-to-child transmission in Israel

N Agmon-Levin MD ^*, D Elbirt MD ^*, I Asher MD ^*, D Torten MD ^*, Y Cohen BA ^*, S Gradestein MD ^*, B Werner MD ^* , D Turner MD , M Chowers MD , G Gottesman MD , S Maayan MD , K Risenberg MD ^**, I Levi MD  and Z Sthoeger MD ^* 

^* Neve-Or AIDS Center, Kaplan Medical Center, Rehovot; Ichilov Medical Center, Tel aviv; Meir Medical Center, Kefar Saba, Israel; Haddasah University Hospital, Jerusalem; ^** Soroka Medical Center, Beer sheva; Sheba Medical Center, Tel Hashomer, Israel

Correspondence to: Professor Z Sthoeger, Department of Internal Medicine B and the AIDS Allergy and Clinical Immunology Unit, Kaplan Medical Center 76100, Rehovot, Israel Email: Zev_s{at}clalit.org.il, sthoeger{at}gmail.com

The objective of the study was to investigate the HIV-mother-to-child transmission (MTCT) rate in Israel. This was a retrospective study of HIV-infected pregnant women, mainly immigrants from Ethiopia, in six Israeli AIDS centres, in 2000–2005. Medical records of mothers and newborns were evaluated for HIV status, treatment and MTCT rates. Three hundred pregnancies of 241 HIV-infected women, resulting in 304 live births, were studied. In 86/241(36%) women, HIV diagnosis was made during the current pregnancy or shortly after labour. Thirty others were diagnosed during previous pregnancies. Highly active antiretroviral therapy (HAART) was prescribed in 76% of pregnancies. The mean viral load before labour was 23,000 ± 100,000 copies/mL with a mean CD4 of 406 ± 223 (range 4–1277) cells/mm³. Caesarian sections were preformed in 175/300 pregnancies (103/175 with viral load <1000 copies/mL). During labour, azidothymidine (AZT) was given to 80% and nevirapine to 8% of the women. Eighty-eight percent of the neonates received AZT for six weeks. The overall HIV-MTCT rate was 3.6%. MTCT correlated significantly with delayed HIV diagnosis, low CD4, lack of HAART during pregnancy and lack of perinatal treatment. HIV treatment of mothers and their newborns throughout pregnancy, labour and perinatal period are crucial for effective prevention of MTCT, emphasizing the need for early HIV screening, diagnosis and treatment.

Key Words: HIV • AIDS • mother-to-child transmission • highly active antiretroviral therapy • Ethiopia • Israel

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