{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T03:16:51Z","timestamp":1775186211441,"version":"3.50.1"},"reference-count":62,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (&lt;100 copies\/mL 2 occasions before or after pregnancy off ART). (2) Methods: A multi-centre, retrospective case series (1999\u20132021) comparing pre- and post-2012 when guidelines departed from zidovudine-monotherapy (ZDVm) as a first-line option. Demographic, virologic, obstetric and neonatal information were anonymised, collated and analysed in SPSS. (3) Results: A total of 49 live births were recorded in 29 women, 35 pre-2012 and 14 post. HIV infection was more commonly diagnosed in first reported pregnancy pre-2012 (15\/35) compared to post (2\/14), p = 0.10. Pre-2012 pregnancies were predominantly managed with ZDVm (28\/35) with pre-labour caesarean section (PLCS) (24\/35). Post-2012 4\/14 received ZDVm and 10\/14 triple ART, p = 0.002. Post-2012 mode of delivery was varied (5 vaginal, 6 PLCS and 3 emergency CS). No intrapartum ZDV infusions were given post-2012 compared to 11\/35 deliveries pre-2012. During pregnancy, HIV was detected (&gt; 50 copies\/mL) in 14\/49 pregnancies (29%) (median 92, range 51\u20136084). Neonatal ZDV post-exposure prophylaxis was recorded for 45\/49 infants. No transmissions were reported. (4) Conclusion: UK practice has been influenced by the change in guidelines, but this has had little impact on CS rates.<\/jats:p>","DOI":"10.3390\/pathogens13040308","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T06:07:46Z","timestamp":1712729266000},"page":"308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pregnancy Management in HIV Viral Controllers: Twenty Years of Experience"],"prefix":"10.3390","volume":"13","author":[{"given":"Charlotte-Eve S.","family":"Short","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London W2 1PG, UK"},{"name":"Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK"},{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Byrne","sequence":"additional","affiliation":[{"name":"School of Medicine, St Georges, University of London, London SW17 0RE, UK"},{"name":"St. George\u2019s University Hospitals NHS Trust, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aishah","family":"Hagan-Bezgin","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London W2 1PG, UK"},{"name":"School of Medicine, University of Liverpool, Liverpool L69 3GE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6074-0607","authenticated-orcid":false,"given":"Rachael A.","family":"Quinlan","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London W2 1PG, UK"},{"name":"Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Anderson","sequence":"additional","affiliation":[{"name":"Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK"},{"name":"London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Brook","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okavas","family":"De Alwis","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemiek","family":"de Ruiter","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"},{"name":"ViiV Healthcare, Brentford TW8 9GS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pippa","family":"Farrugia","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Fidler","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London W2 1PG, UK"},{"name":"Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK"},{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleanor","family":"Hamlyn","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Hartley","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London E1 1BB, UK"},{"name":"Leeds University Teaching Hospital NHS Trust, Leeds LS1 3EX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siobhan","family":"Murphy","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Noble","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London E1 1BB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4558-4036","authenticated-orcid":false,"given":"Soonita","family":"Oomeer","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"},{"name":"Central and North West London NHS Foundation Trust, London NW1 3AX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherie","family":"Roedling","sequence":"additional","affiliation":[{"name":"Central and North West London NHS Foundation Trust, London NW1 3AX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Rosenvinge","sequence":"additional","affiliation":[{"name":"Lewisham and Greenwich NHS Trust, London SE13 6LH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1614-125X","authenticated-orcid":false,"given":"Luciana","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rimi","family":"Shah","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selena","family":"Singh","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London E1 1BB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Thorne","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London W2 1PG, UK"},{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Toby","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London E1 1BB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenton","family":"Wait","sequence":"additional","affiliation":[{"name":"Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liat","family":"Sarner","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London E1 1BB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3773-2390","authenticated-orcid":false,"given":"Graham P.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London W2 1PG, UK"},{"name":"Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK"},{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.immuni.2007.08.010","article-title":"Human immunodeficiency virus controllers: Mechanisms of durable virus control in the absence of antiretroviral therapy","volume":"27","author":"Deeks","year":"2007","journal-title":"Immunity"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1080\/21505594.2020.1788887","article-title":"Elite controllers: A heterogeneous group of HIV-infected 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