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Epidemiology and detection of human immunodeficiency
virus among pregnant women in Hong Kong
KM Ho, KK Ho, WL Lim, P Li, KH Wong
Department of Health Special Preventive Programme, Integrated Treatment
Centre, Kowloon Bay Health Centre, 9 Kai Yan Street, Kowloon Bay,
Hong Kong
OBJECTIVES. To determine the epidemiology of human
immunodeficiency virus infection among pregnant women and the neonatal
outcomes in Hong Kong.
DESIGN. Retrospective observational study composed of two parts:
record review of pregnant women and unlinked anonymous screening
of cord blood from neonates.
SETTING. Two human immunodeficiency virus clinics and the Government
Virus Unit.
PARTICIPANTS. Female patients attending the two clinics who became
pregnant and neonates who underwent routine metabolic screening
by the Government Virus Unit between 1992 and 1999.
MAIN OUTCOME MEASURES. The outcomes of neonates born to women who
had human immunodeficiency virus infection during pregnancy.
RESULTS. Forty-one human immunodeficiency virus–related pregnancies
were recorded among 32 infected women. Fifteen pregnancies were
terminated, of which 14 were in women who knew their infection status
before conception. Twenty-six pregnancies continued to term, resulting
in 26 live births. Twelve babies were born to women who knew their
infection status before delivery. One baby was confirmed to be infected.
Six women were given zidovudine for prophylaxis against vertical
transmission and none of the babies were infected at birth. Of the
remaining 14 human immunodeficiency virus–related pregnancies,
the mothers’ status became known only at a later date and nine
(64.3%) babies were confirmed to be infected at the age of 18 months
or older. The rate ratio of giving birth to an infected baby was
8.18 from mothers who did not know their status antenatally. Unlinked
anonymous screening showed that the seroprevalence rate for human
immunodeficiency virus in pregnant women was 0.032% (1/3125) in
Hong Kong in 1999.
CONCLUSIONS. Human immunodeficiency virus–related pregnancy
is not rare in Hong Kong and the majority of infected mothers were
not identified and treated. Detection of these pregnancies will
be invaluable for the prevention of mother-to-child transmission.
Universal antenatal screening of human immunodeficiency virus antibody
is proposed as an effective strategy.
Hong Kong Med J 2001;7:335-42
Key words: Disease transmission, vertical; HIV infections/transmission;
Hong Kong; Neonatal screening; Prenatal diagnosis
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