Open Access Highly Accessed Research article

Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective

Eline LM Op de Coul1*, Susan Hahné1, Yolanda WM van Weert1, Petra Oomen1, Colette Smit2, Kitty PB van der Ploeg3, Daan W Notermans4, Kees Boer5 and Marianne AB van der Sande1

Author Affiliations

1 Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

2 Stichting HIV Monitoring, Academic Medical Centre of the University of Amsterdam, the Netherlands

3 TNO quality of life, department of Prevention and Healthcare, Leiden, the Netherlands

4 Laboratory of Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

5 Academic Medical Centre, department of gynaecology, University of Amsterdam, the Netherlands

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BMC Infectious Diseases 2011, 11:185  doi:10.1186/1471-2334-11-185

Published: 30 June 2011

Abstract

Background

A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV, hepatitis B virus (HBV) and syphilis in preventing mother-to-child transmission, by using various data sources.

Methods

The results of antenatal screening (2006-2008) were compared with data from pregnant women and newborns from other data sources.

Results

Each year, around 185,000 pregnant women were screened for HIV, HBV and syphilis. Refusal rates for the screening tests were low, and were highest (0.2%) for HIV. The estimated annual prevalence of HIV among pregnant women was 0.05%.

Prior to the introduction of screening, 5-10 children were born with HIV annually After the introduction of screening in 2004, only 4 children were born with HIV (an average of 1 per year). Two of these mothers had become pregnant prior to 2004; the third mother was HIV negative at screening and probably became infected after screening; the fourth mother's background was unknown. Congenital syphilis was diagnosed in fewer than 5 newborns annually and 5 children were infected with HBV. In 3 of these, the mothers were HBeAg positive (a marker for high infectivity). We estimated that 5-10 HIV, 50-75 HBV and 10 syphilis cases in newborns had been prevented annually as a result of screening.

Conclusions

The screening programme was effective in detecting HIV, HBV and syphilis in pregnant women and in preventing transmission to the child. Since the introduction of the HIV screening the number of children born with HIV has fallen dramatically.

Previous publication

[Translation from: 'Prenatale screening op hiv, hepatitis B en syphilis in Nederland effectief', published in 'The Dutch Journal of Medicine ' (NTVG, in Dutch)]