Department of Pediatrics, University of Alberta, Edmonton, Canada.
STI Clinic, Edmonton General Hospital, Edmonton, Canada.
Curr HIV Res. 2021;19(3):269-276. doi: 10.2174/1570162X18999201231211658.
HIV transmission during pregnancy and breastfeeding among serodiscordant heterosexual couples represents an ongoing barrier to the elimination of vertical transmission of HIV-1 infection in Canada.
To report a case of vertical HIV transmission during breastfeeding and examine the prevalence of risk factors for HIV transmission in the pregnancy and postpartum periods among serodiscordant couples where the male partner is HIV positive and female partner HIV negative.
Case report and retrospective chart review of HIV-serodiscordant pregnant couples over an eight-year period in Edmonton, Canada.
We report a case of maternal primary HIV infection during the postpartum period and vertical transmission to a nursing infant that went undetected until the infant presented with AIDS. We also report a series of 41 serodiscordant pregnant couples identified by our public health nurse between 2008 and 2016. Among HIV-infected male partners, 20 (49%) had a detectable viral load (VL) during their partner's pregnancy and during breastfeeding, with median peak VL 4,700 copies/mL (range 49-120,000) and 5,100 copies/mL (range 40-120,000) during pregnancy and breastfeeding, respectively. None of the female partners seroconverted during pregnancy, but three seroconverted at 1.8, 2.4, and 6.9 years after delivery. No vertical transmission occurred.
Despite concerted attempts to minimize HIV transmission during pregnancy and breastfeeding in our well-resourced setting, residual transmission risk remains due to non-suppressed viral load within many HIV-serodiscordant pregnant couples.
在血清不一致的异性恋夫妇中，妊娠和哺乳期的 HIV 传播仍然是加拿大消除 HIV-1 垂直传播的一个障碍。
报告一例母乳喂养期间垂直传播 HIV 的病例，并检查在男性 HIV 阳性、女性 HIV 阴性的血清不一致夫妇中，妊娠和产后期间 HIV 传播的危险因素的流行情况。
对加拿大埃德蒙顿市 8 年来血清不一致的妊娠夫妇进行病例报告和回顾性图表审查。
我们报告了一例产妇在产后期间原发性 HIV 感染和垂直传播给哺乳婴儿的病例，直到婴儿出现艾滋病时才被发现。我们还报告了 2008 年至 2016 年间我们的公共卫生护士发现的一系列 41 对血清不一致的妊娠夫妇。在 HIV 感染的男性伴侣中，20 名（49%）在其伴侣怀孕期间和哺乳期有可检测到的病毒载量（VL），中位峰值 VL 分别为 4700 拷贝/mL（范围 49-120,000）和 5100 拷贝/mL（范围 40-120,000）。没有女性伴侣在怀孕期间发生血清转换，但有 3 名在产后 1.8、2.4 和 6.9 年时发生血清转换。没有发生垂直传播。
尽管在我们资源充足的环境中，我们已努力集中精力降低妊娠和哺乳期的 HIV 传播风险，但由于许多血清不一致的妊娠夫妇的病毒载量未得到抑制，仍然存在残留的传播风险。
