[HIV Screening for Pregnant Women in Israel: Evaluation of Current Selective Screening Recommendations in the Light of the Local Epidemiology]

Introduction: HIV-testing in Israel for pregnant women (PW) is selective since the year 1998 and recommended if they or their sex partners (SP] are at high-risk for HIV-infection. HIV-infected PW, citizens and non-citizens alike, are eligible for free HIV-care and treatment. This study describes the current recommendations and HIV epidemiology in Israel.

Methods: A retrospective study was conducted describing risk groups of HIV-infected PW between the years 1985 and 2010. The source of the data was the National HIV registry.

Results: During 25 years of follow-up, 204 vertically HIV-infected children were reported to the Ministry of Health (MoH). Of those, 87 (42.4%) were born in Israel to 83 PW, and the others were born overseas. Of these 87 children, 35 (40.2%) were born to 33 PWwho were unaware of their HIV-infection prior to Labor (31 citizens and 2 non-citizens). Of those, 22 (66.7%) were born in high-prevalence countries, eight (24.3%) were infected from their heterosexual SP, one (3%) used drugs intravenously, one (3%) had a SPwho used drugs intravenously, and one (3%) had a SP who received HIV-infected blood. During the period 2002-2011, the treatment costs of 54 non-citizens PW was covered by the MoH and no vertical infection was diagnosed.

Conclusions: Most vertical transmissions occurred overseas, or by PW who were aware of their infection prior to Labor. Most of the PW who were unaware of their HIV-infection and gave birth in Israel belonged to the known risk groups for whom testing is recommended. SeLective HIV-testing in these PW should be encouraged, along with a vigilant surveiLLance of new HIV-infections in women.