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Treatment and pregnancy outcome in pregnant women with HIV infection diagnosed through opt-out screening versus patients engaged in HIV care before conception N.J. 1 Kleinrensink , A.C.C. Van 2 Oppen , T. Mudrikova 1 1Dept of Internal Medicine & Infectious Diseases, 2 Dept of Gynecology and Obstetrics, University Medical Center Utrecht Conclusions Although having got the diagnosis of HIV infection through the opt-out screening program was not associated with higher proportion of detectable viremia at delivery, emergency caesarean section was necessary in a significantly higher proportion of these patients when compared with patients with known HIV infection at conception. Introduction In 2004, a non-selective opt-out screening program for human immunodeficiency virus (HIV) in pregnant women was implemented in the Netherlands. This analysis aimed to evaluate the efficiency of antiretroviral treatment and pregnancy outcomes in patients who were diagnosed through the opt-out program compared to women with known HIV infection at conception. Methods • a single-center retrospective cohort study of pregnant women in UMC Utrecht between 01-01-2004 and 01-032015 • only first pregnancy after HIV diagnosis included • possible risk factors for a detectable plasma HIV RNA viral load (VL) at delivery analyzed using the chi-square or Fisher’s exact test • statistically significant risk factors subsequently analyzed in a multivariate logistic regression analysis Results 78 pregnancies were included: • 32 patients diagnosed through opt-out screening (group 1) • 46 patients had known HIV infection by conception (group 2) Only baseline VL >100.000 copies/ml was significantly associated with detectable VL at delivery after multivariate analysis (see Table 1; P 0.05). Patients diagnosed with HIV during pregnancy underwent significantly more emergency caesarean sections than patients with known HIV infection at conception (50% vs. 19.6%, resp.; P 0.05), mostly due to (suspected) fetal stress (Table 2). Discussion Diagnosis of HIV infection before or during pregnancy was not associated with detectable VL at delivery, which is in accordance with a recent U.S. multicenter study1. The number of emergency caesarean sections was higher in the opt-out group than expected, based on previous research2 in HIV-infected pregnant women2. References 1.Katz IT, Leister E, Kacanek D, et al. Factors Associated With Lack of Viral Suppression at Delivery Among Highly Active Antiretroviral Therapy-Naive Women With HIV: A Cohort Study. Ann Intern Med. 2015;162(2):9099. doi:10.7326/M13-2005. 2.Boer K, Nellen JF, Patel D, et al. The AmRo study: pregnancy outcome in HIV-1-infected women under effective highly active antiretroviral therapy and a policy of vaginal delivery. BJOG. 2007;114(2):148-155. . NCHIV 2015 [email protected]