Clinical management of pregnancy, delivery and breastfeeding in women living with HIV in Italy: A survey of participating infectious diseases centres
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Management of pregnancy in women living with HIV is evolving in high-income settings, with increasing attention to infant feeding under sustained virological suppression. Real-world data from Europe remain limited. This study aimed to describe self-reported organizational models and routine approaches to clinical care in participating Italian infectious diseases centres. METHODS: An online survey was conducted among Italian infectious diseases centres via the Italian Cohort of Antiretroviral-Naïve Patients (ICAR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) networks. The questionnaire explored organizational models, ART management, delivery, neonatal prophylaxis and breastfeeding. Data were analysed descriptively. RESULTS: Forty-one centres from 15 regions participated, reporting approximately 300 women living with HIV pregnancies in 2024. Most centres (78.0%) had local pregnancy protocols, typically involving multidisciplinary teams. Reported practices varied across several aspects of care, including ART management during pregnancy, obstetric follow-up, mode of delivery and neonatal prophylaxis. Elective caesarean section (CS) was recommended irrespective of virological status in 9.8% of centres; routine intrapartum intravenous zidovudine was reported in 17.1%. Neonatal zidovudine prophylaxis was used by 90.2% of centres (duration: 2-6 weeks). Requests for breastfeeding were reported by 53.7% of centres; eight centres supported breastfeeding under strict clinical conditions, involving 36 women. CONCLUSIONS: This survey highlights substantial heterogeneity in self-reported organizational models and reported practices among participating Italian infectious diseases centres caring for pregnant women living with HIV. Although direct clinical experience with supported breastfeeding remains limited, the findings support the development of harmonized, evidence-based guidance to promote equitable multidisciplinary care and informed shared decision-making and provide a framework for greater consistency in pregnancy and infant feeding management.
Source: HIV Medicine
DOI: 10.1111/hiv.70308
Authors: Daniela Piacentini, Lavinia Cosimi, Antonella Castagna, Annamaria Cattelan, Andrea Antinori, Vincenzo Esposito, Nicoletta Frattini, Vania Giacomet, Giuseppina Giupponi, Sergio Lo Caputo, Paolo Meli, Cristina Mussini, Giuseppe Nunnari, Saverio G. Parisi, Stefano Rusconi, Massimiliano Lanzafame
Institutions: University of Trieste, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, Azienda Ospedale - Università Padova, Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Ospedale D. Cotugno, University of Milan, Luigi Sacco Hospital, University of Foggia, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, University of Catania, Ospedale Garibaldi, University of Padua, Aziende Socio Sanitarie Territoriale Ovest Milanese, University of Trento, Ospedale Santa Chiara
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7213344873