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IntroductionHIV infection during pregnancy still raises controversial issues. Combined antiretroviral therapy (cART) has been successful in reducing mother‐to‐child transmission (MTCT). Routine screening in pregnancy and in pre‐conception consultation proved to be one of the best methods able to get this treatment on time. We review our experience with pregnant patients with HIV infection.Materials and MethodsRetrospective and descriptive study. Data obtained from HIV‐infected pregnant women from 1999 to 2012 with delivery and subsequent infectious diseases follow‐up at our hospital.ResultsWe evaluated 136 patients (169 pregnancies), with a total of 147 living newborns (2 twin pregnancies) and 1 stillbirth. Median age at pregnancy was 30 (SD 5.7) years. Four patients were HIV‐2 infected and one HIV‐1+2 infected. 26 (19.1%) women were HCV co‐infected and 6 (4.4%) HBV co‐infected; 1 patient has HCV and HBV co‐infection. Sexual risk for HIV acquisition was determined in 102 (75%) patients and 31 (22.8%) were intravenous drug users. 33/136 (24.2%) women were diagnosed on routine screening in pregnancy, 4 during delivery and 2 immediately after delivery. 36 (26.4%) patients had an AIDS‐defining entity before pregnancy and no new opportunistic infections were diagnosed. ART was used in 157 (92.9%) pregnancies and 15 (9.5%) of them were treated only with NRTIs. At the time of delivery 86/144 (59.7%) patients had undetectable viral load (VL) (25 patients without VL determined), 91.7% of those on ART. 119 (70.4%) had a TCD4 cell count above 200 cells/mm3. MTCT occurred in 3/147 cases (2%): in one mother HIV‐1 infection was diagnosed three weeks before delivery, other immediately after delivery and the third woman started cART (2NRTI+1PI/r) in the second trimester of pregnancy, always adherent and without secondary effects, VL at delivery was 50 copies/mL and elective C‐section was performed.ConclusionsThe fact that 24% of patients were diagnosed during pregnancy shows the importance of routine screening to all pregnant women. MTCT occurred in three children, but only one was administered cART for prevention.

IntroductionPresence of viral mutations conferring resistance to antiretroviral drugs has potential impact on success of antiretroviral therapy (ART). The aim of this study was to describe the prevalence of resistance‐associated mutations in HIV‐infected patients without prior ART in a Portuguese cohort.Materials and MethodsRetrospective single‐centre study of patients newly diagnosed with HIV‐1 infection between 2006 and 2012. Resistance genotyping was obtained with HIV TRUGENE® and Viroseq® tests and the analysis of drug resistance was based on the Stanford University HIV Drug Resistance Database. Epidemiological data was also gathered. Continuous variables were summarized by mean and standard deviation, whereas categorical variables were presented as proportions. Comparison of proportions was performed with Chi square and Fisher exact test while means were compared with Student test. Statistical significance was assumed when p<0.05. Statistical analysis was performed with SPSS 21.0®.ResultsResistance testing was performed in 624 patients. General characteristics of the patients are summarized in Table 1. Mutations were found in 291 (46.6%) patients but resistance‐associated mutations were present in 79 (12.7%) patients. Resistances to different drug classes were the following: NNRTIs‐resistance in 42 (6.7%) patients; NRTIs‐resistance in 19 (3.0%) patients; PIs‐resistance in 30 (4.8%) patients. Only 10 (1.6%) patients presented simultaneous resistance‐associated mutations to more than one class of drugs. There were no statistical significant differences between the years at which HIV‐1 was diagnosed. Also no significant difference in the distribution of the parameters age, sex, CD4‐cell count, and viral load, between groups with and without resistance was identified. Resistance‐associated mutations were significantly more common in patients with non‐B HIV‐1 subtypes (15.4% vs 9.8%; p=0.048) and in those presenting with AIDS (18.2% vs 11.1%; p=0.03).ConclusionsPrevalence of resistance‐associated mutations identified in this study was similar to those reported in similar studies from Western Europe. Knowledge about the epidemiology of primary resistance in our country is important in order to improve HIV care.