Résumé
Background: since the discovery of Mother To Child Transmission (MTCT) of Human Immunodeficiency Virus (HIV), prevention of MTCT has been a priority. Today, guideline adherence has reduced MTCT to nearly 0. Material and methods: our retrospective cohort study included HIV-positive women with a history of delivery in our hospital between 2000 and 2020. We sought to examine our centre’s practices, outcomes, and illustrate the changes in management of HIV pregnant women. Based on French medical guidelines, we defined significant time periods which were compared to assess changes in our practice. Results: we included 194 pregnancies, in 144 women, with 201 live births. Between 2000 and 2020, we report a gradually smaller proportion of pregnant HIV infected women; 27 (13.9%) women discovered their HIV-positive status during pregnancy. Anti-Retroviral Therapy (ART) prophylaxis was started earlier, planned break from treatment was dropped and monotherapy was replaced by boosted triple therapy (p less than 0.01). Patients increasingly delivered vaginally, and intrapartum intravenous zidovudine was seldom used after 2013 (p less than 0.01). Almost 98% of new-borns received prophylaxis at discharge and 91.3% of infants had at least 6 months of follow-up. We report only one case of MTCT, in 2000. Conclusion: our study illustrates the major changes for the prevention of HIV MTCT. Expert management progressively centred around early triple ART, led to better obstetrical outcomes requiring fewer medical interventions, all while keeping MTCT risk at the lowest.