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Infection

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Impact of refugee influx on the epidemiology of late-presenting HIV-infected pregnant women and mother-to-child transmission: comparing a southern and northern medical centre in Germany

  • Katharina Singer
  • Ulf Schulze-Sturm
  • Irene Alba-Alejandre
  • Bettina Hollwitz
  • Thi Thanh Truc Nguyen
  • Franz Sollinger
  • Josef Eberle
  • Johannes Hübner
  • Robin Kobbe
  • Orsolya Genzel-Boroviczény
  • Ulrich von BothEmail author
Original Paper

Abstract

Purpose

Due to early antenatal screening and treatment, HIV mother-to-child transmission (MTCT) rarely occurs in Germany. The study aimed to investigate the impact on prevalence of HIV infection in the antenatal population and the incidence of late-presenting HIV-infected mothers attributable to increased numbers of refugees.

Methods

Retrospective analysis and comparison were performed for all deliveries in HIV-infected pregnant women presenting to medical care in Munich (southern Germany) and Hamburg (northern Germany) covering two time periods, A (2010–2012) and B (2013–2015).

Results

In Munich, deliveries in HIV-infected pregnant women increased 1.6-fold from period A (n = 50) to B (n = 79) with late-presenting cases rising significantly from 2% (1/50) in period A to 13% (10/79) in B. In contrast, late-presenting cases in Hamburg decreased from 14% (14/100) in period A to 7% (7/107) in B, while the total number of HIV-infected women giving birth remained stable. From 2010 to 2015, one late-presenting pregnant woman transmitted HIV in Munich by presumed in utero mode of infection (case reviewed here), while no MTCT occurred in Hamburg.

Conclusions

HIV infections diagnosed late in pregnancy and leading to delayed ART initiation are rising in Munich compared to Hamburg. Antenatal care of HIV-infected pregnant women in Munich appears to have been more affected by the recent refugee influx than Hamburg. Our study highlights the importance of screening all pregnant women for HIV early in pregnancy and providing timely health care access for pregnant refugees and asylum seekers to effectively prevent MTCT in Germany.

Keywords

HIV Mother-to-child transmission MTCT Late presenting Refugees 

Notes

Acknowledgements

The authors like to thank Dr Andrew Prendergast for advice and critical review of the manuscript and Karen Olah and Sandra Hertling for their support in finalizing maternal data in Hamburg.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Katharina Singer
    • 1
    • 2
  • Ulf Schulze-Sturm
    • 3
  • Irene Alba-Alejandre
    • 4
  • Bettina Hollwitz
    • 5
  • Thi Thanh Truc Nguyen
    • 3
  • Franz Sollinger
    • 2
  • Josef Eberle
    • 6
    • 7
  • Johannes Hübner
    • 2
    • 7
  • Robin Kobbe
    • 3
  • Orsolya Genzel-Boroviczény
    • 1
  • Ulrich von Both
    • 2
    • 7
    Email author
  1. 1.Division of Neonatology Campus Innenstadt, Dr. von Hauner Children’s Hospital, University HospitalLudwig-Maximilians-University (LMU) MunichMunichGermany
  2. 2.Division of Paediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University HospitalLudwig-Maximilians-University (LMU) MunichMunichGermany
  3. 3.Department of PaediatricsUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Department of Obstetrics and GynaecologyLudwig-Maximilians-University (LMU) MunichMunichGermany
  5. 5.Department of Obstetrics and Prenatal MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  6. 6.Division of Virology, National Reference Center for Retroviruses, Max von Pettenkofer-Institute for Hygiene and Clinical MicrobiologyLudwig-Maximilians-University (LMU) MunichMunichGermany
  7. 7.German Center for Infection Research (DZIF)MunichGermany

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