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<p>We aimed to review perinatal outcomes in HIV-positive pregnant women and their infants, as well as Turkish clinicians’ approaches to the management of HIV in pregnancy. This multicenter cohort study included pregnant women living with HIV (WLWH) across Türkiye from 2010 to 2024. 209 pregnancies among 162 WLWH were identified. Nearly 90.9% were diagnosed before or during pregnancy, and 90% were on antiretroviral therapy (ART) at delivery. 150 women had viral loads of less than 1,000 copies/mL during labor. The most chosen ART combination during pregnancy was tenofovir/emtricitabine+raltegravir. Most common mode of delivery was cesarean section&#xa0;(78.9%). Among 174 deliveries, 22 (12.6%) were preterm. Regarding newborn prophylaxis, 137 (88.4%) received zidovudine and 34 received nevirapine. 14 infants were breastfed. No congenital malformation, neonatal or maternal mortality was observed. Overall, 13 infants were diagnosed HIV-positive, indicating an MTCT rate of 7.9% in this cohort. Breastfeeding (OR: 30.1, 95% CI: 4.70-193.50, <i>p</i> &lt; .001) and absence of ART during pregnancy (OR: 30.9, 95% CI: 5.20-183.90, <i>p</i> &lt; .001) were the most prominent variables affecting the infants’ HIV positivity. Despite efficient preventative strategies announced over years, we report a high MTCT rate of 7.9%, aligning with previous literature from Türkiye. The findings highlight that the absence of ART and breastfeeding remain critical risk factors for perinatal HIV transmission. This large real-world cohort, reflecting Turkish clinicians’ practices, helps define major gaps in MTCT prevention in the modern ART era and provides valuable evidence to inform clinicians, policy makers, and public health strategies.</p>

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HIV and Pregnancy in Türkiye: Gaps and Gains in the Era of Modern ART: A Multicenter Cohort Study

  • 期刊论文

  • 发表日期：

    2026年2月17日

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  • Tuba Damar Çakırca,
  • Behice Kurtaran,
  • Özlem Aydın,
  • Bircan Kayaaslan,
  • Bülent Kaya,
  • İlkay Karaoğlan,
  • Ayşe Özlem Mete,
  • Nazan Tuna,
  • Nurgül Ceran,
  • İlknur Esen Yıldız,
  • Fethiye Akgül,
  • Pınar Ergen,
  • Gönül Çiçek Şentürk,
  • Veysel Akça,
  • Çiğdem Mermutluoğlu,
  • Derya Öztürk Engin,
  • Gül Ruhsar Yılmaz,
  • Mustafa Kemal Çelen,
  • Onur Kaya,
  • Ayhan Akbulut,
  • Mehmet Ali Aşan,
  • Özgür Günal,
  • Şeyma Topal,
  • Hatun Öztürk Çerik,
  • Mehmet Çabalak,
  • Recep Balık,
  • Seniha Şenbayrak,
  • Aslı Vatan,
  • Gökçen Gürkök Budak,
  • Aslıhan Candevir,
  • Yeşim Taşova

摘要

We aimed to review perinatal outcomes in HIV-positive pregnant women and their infants, as well as Turkish clinicians’ approaches to the management of HIV in pregnancy. This multicenter cohort study included pregnant women living with HIV (WLWH) across Türkiye from 2010 to 2024. 209 pregnancies among 162 WLWH were identified. Nearly 90.9% were diagnosed before or during pregnancy, and 90% were on antiretroviral therapy (ART) at delivery. 150 women had viral loads of less than 1,000 copies/mL during labor. The most chosen ART combination during pregnancy was tenofovir/emtricitabine+raltegravir. Most common mode of delivery was cesarean section (78.9%). Among 174 deliveries, 22 (12.6%) were preterm. Regarding newborn prophylaxis, 137 (88.4%) received zidovudine and 34 received nevirapine. 14 infants were breastfed. No congenital malformation, neonatal or maternal mortality was observed. Overall, 13 infants were diagnosed HIV-positive, indicating an MTCT rate of 7.9% in this cohort. Breastfeeding (OR: 30.1, 95% CI: 4.70-193.50, p < .001) and absence of ART during pregnancy (OR: 30.9, 95% CI: 5.20-183.90, p < .001) were the most prominent variables affecting the infants’ HIV positivity. Despite efficient preventative strategies announced over years, we report a high MTCT rate of 7.9%, aligning with previous literature from Türkiye. The findings highlight that the absence of ART and breastfeeding remain critical risk factors for perinatal HIV transmission. This large real-world cohort, reflecting Turkish clinicians’ practices, helps define major gaps in MTCT prevention in the modern ART era and provides valuable evidence to inform clinicians, policy makers, and public health strategies.