Cohort profile: the Swiss Mother and Child HIV Cohort Study (MoCHiV). BMJ Open
The prevention of vertical transmission, as well as the improvement of pregnancy care, are key to delivering optimal care for people with HIV. In collaboration with the Swiss HIV Cohort Study, the Swiss Mother and Child HIV Cohort Study (MoCHiV) collects longitudinal data on women with HIV and their children. In this article published in BMJ Open, Paioni et al. provide the cohort profile and describe key metrics of MoCHiV.
Pregnant women with HIV registered in the SHCS, children born to women with HIV, and children with HIV are eligible for MoCHiV. Pregnant women generally follow the routine follow-up visits of the Swiss HIV Cohort Study. All children born to women with HIV have HIV-PCR measured 1 and 6 months after delivery, together with an antibody screening test at the age of 18-24 months to rule out vertical transmission. Children with HIV are followed every 6 months, and detailed information on laboratory and clinical parameters is collected.
Between January 1986 and December 2022, MoCHiV collected data on 1’041 pregnant women. At birth, the median age was 30 years, 79% acquired HIV through heterosexual contacts, and 44% were of African origin. The women gave birth to 1’446 children, of which 15% were preterm deliveries. Between 1986 and 2022, 98 children (7%) were born with HIV. In addition to the 1’446 children described above, MoCHiV includes information on 708 children exposed to HIV (incl. 187 children living with HIV) without information about the mother. Of the 285 children with HIV, 33% were lost to follow-up or voluntarily withdrew from the study, 21% died, 6% continue to be followed in MoCHiV, and 40% have reached adulthood and are now followed within the SHCS.
Research by MoCHiV has strongly influenced the measures to prevent vertical transmission of HIV, highlighting the importance of the study. These include the discontinuation of elective cesarean section, the discontinuation of neonatal postexposure prophylaxis, and the possibility of breastfeeding in a shared decision-making approach for children born to women with stable HIV suppression during pregnancy in Switzerland.