Graph MoCHiV
State of the MoCHiV cohort
Overview of children
Since the beginning of the HIV epidemic in the early eighties data of 1540 children - of whom 227 were HIV positive - have been registered into MoCHiV (fig 1). We currently try to complete the missing infectious status.
The two sexes are equally well represented with 762 boys (49.5 %) and 768 (50.5%) girls. (10 unknown)
The largest proportion of children were recruited in Zürich (27.8 %) (fig 2).
Of the total of 257 HIV positive children 52 were lost from follow-up, 61 have died, 86 reached the adulthood (of whom 32 are followed now within the adult cohort SHCS) and 100 are currently under follow-up.
Most of the HIV positive children who are currently under follow-up, are treated with a combined antiretroviral therapy.
Of the HIV negative children 196 are currently under follow-up.
Vertical transmission and mode of delivery
Figure 3 shows the transmission rate according to MoCHiV. Children who were recruited after birth were excluded from the calculation.
During the first years no interventions at all were available to reduce vertical transmission and transmission rates were high in the range between 20 and 25%. Later on, preventive interventions became available, and transmission rate started to decline steadily. First antiretroviral monotherapy with Zidovudine, then in combination with elective cesarean section (ECS) and most recently ECS in combination with highly active antiretroviral therapy were considered as the prevention of choice. Currently the vertical transmission rate has declined to 0%.
The change in the mode of delivery over the years is demonstrated in figure 4.
Current practice (since 2003). N=104 women
Since the year 2003 all pregnant women of the SHCS and their children should be included in MoCHiV.
Here we show some characteristics of the mothers since this reorganisation process.
Demographic characteristics of mothers
| HIV transmission category | heterosexual | 88% |
| intravenous drug use | 11% | |
| unknown | 1% | |
| Age of mother at delivery (years) | < 25 | 9% |
| 26-30 | 24% | |
| 31-35 | 34% | |
| 36-40 | 26% | |
| > 40 | 7% |
Antiretroviral treatment during pregnancy:
Most of the women (62%) were already treated before pregnancy, 1% has started antiretroviral therapy in the first trimester of pregnancy, 22% in the second and 11% in the third trimester. For 4% of the women their treatment status during pregnancy is unknown or they were not treated.
Forty-seven percent of the women received AZT prophylaxis during delivery.
Entry in SHCS in relation to birth
23 % of the women were recruited in the SHCS only during pregnancy. Of the women who were already followed in the SHCS when they became pregnant, 14% started ART only during pregnancy.
CD4 and RNA before delivery:
For 94% of the women the viral load was undetectable or below 400 within 2 months before delivery, 5% had a viral load between 400 and 5000 and for 1% the viral load was above 5000.
The CD4 cell count was > 500 for 39% of the women, between 350 and 500 for 27% and for 35% it was below 350.
Birth rate
In the SHCS it is documented if a birth took place since the last follow-up of the woman.
Of the approximate 1500 women followed during a year, about 50 to 60 give birth to a child.