Final Programme

Joint RCOG/BHIVA
Multidisciplinary Conference

HIV in Pregnancy
Friday 20 January 2012
Royal College of Obstetricians and Gynaecologists
London

Sponsored by

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

RCOG/BHIVA Multidisciplinary Conference: HIV in Pregnancy

Friday 20 January 2012

INTRODUCTION
Dear Colleague

e are delighted to welcome you on behalf of the Royal College of Obstetricians and Gynaecologists and the
British HIV Association to this conference on HIV in pregnancy, bringing together obstetricians, HIV physicians,

midwives, epidemiologists and peer supporters to review the key management issues in this specialist area.
High rates of new HIV infections, coupled with increased longevity from improved therapy, mean that the
prevalence of HIV in women is increasing. In 2010 34% of new HIV diagnoses were made in women, and
approximately one-third of those living with HIV in the UK are women. As treatments for HIV improve, leading to
better health, increased life expectancy and reductions in the risk of both vertical and horizontal transmission, so the
number of women living with HIV who are choosing to become pregnant is increasing.
Management of HIV in pregnancy, ensuring the best long-term outcomes for both the mother and baby, presents
a variety of challenges to those providing maternity care. Major advances in therapy have been made in the last two
decades, resulting in a dramatic reduction in the risk of vertical transmission of HIV. However, opinion about the
optimum obstetric management is still often based on data from the pre-HAART era. Key issues include premature
delivery, the management of premature rupture of membranes, emergency caesarean section, infant feeding and
patients with HIV and hepatitis co-infection, all of which will be discussed within this conference.
The programme will be delivered by a range of practising clinicians HIV physicians, obstetricians and specialist
midwives, all of whom have significant hands-on experience in the management of HIV in pregnancy. Many of the
speakers sit on the British HIV Association (BHIVA) writing committee for the 2012 national guidelines for the
management of HIV in pregnancy.
Lectures reviewing the evidence for recommendations, clinical cases and panel discussions with delegates will allow
a review of the current evidence and a consideration of how best to put this into real-world practice. We are also
fortunate in having several international speakers to help put UK practice into the wider global context.
We would like to thank all our speakers and panel discussants for giving of their time to speak and share their
expertise, and we extend our thanks to our sponsors whose generosity has allowed us to deliver the programme
without cost to delegates.
We very much hope you will enjoy the conference and find it relevant to both your educational and practical
needs.

Miss Ranee Thakar MD MRCOG

Honorary Director of Conferences, RCOG

Professor Jane Anderson,

Chair, BHIVA

CONFERENCE STEERING COMMITTEE

Professor Jane Anderson (Chair)
Dr David Asboe

Chelsea and Westminster Hospital, London

Professor Peter Brocklehurst

Dr Annemiek de Ruiter

University College London Hospital

St Thomas Hospital, London

Mr Ed Dorman

Homerton University Hospital, London

Dr Yvonne Gilleece

Royal Sussex County Hospital, Brighton

Miss Kate Harding

Guys and St Thomas NHS Foundation Trust, London

Miss Naomi Low-Beer

Imperial College London

Ms Alison Perry

St Jamess University Hospital, Leeds

Professor James Walker

University of Leeds

6 CPD Credits

Homerton University Hospital, London

Unique reference number: 69602

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

RCOG/BHIVA Multidisciplinary Conference: HIV in Pregnancy

Friday 20 January 2012

CONFERENCE INFORMATION
Conference venue
Royal College of Obstetricians and Gynaecologists
27 Sussex Place Regents Park London NW1 4RG
Telephone: 020 7772 6245 Fax: 020 7772 6388

Registration
Registration includes access to the scientific sessions, exhibition and refreshments as outlined in the
conference programme.

Delegate badges
Badges must be worn at all times to gain access to the lecture theatre and catering areas.

Continuing Professional Development (CPD)

Medical staff in career grade posts who are enrolled with one of the Royal Medical Colleges for Continuing
Professional Development will be entitled to receive CPD credits at the rate of one per conference hour.
Please be advised that the attendance list for the conference will be kept on file for reference by the
appropriate Royal Colleges.
This event has been allocated 6 CPD credits and, for those who are registered for CPD accreditation with
the Royal College of Physicians, the unique reference code is 69602 .

Travel
Train:

Marylebone Station 10 minutes walk

Underground:

Baker Street Station 10 minutes walk

Parking:

Regents Park Outer Circle (pay and display)

NCP on corner of Park Road and Rossmore Road, telephone: 0870 242 7144 for further
information.

Accommodation
Please visit: www.rcog.org.uk/events/accommodation for local accommodation and delegate rate
information.

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

RCOG/BHIVA Multidisciplinary Conference: HIV in Pregnancy

Friday 20 January 2012

PROGRAMME
08450915

Registration and coffee

09150920

Introduction
Professor Jane Anderson, Chair, British HIV Association (BHIVA)
Professor James Walker, Senior Vice-president, Royal College of Obstetricians and Gynaecologists (RCOG)

Session One Chair: Professor Peter Brocklehurst, University College London

09200930

Epidemiology of HIV among pregnant women in the UK and Ireland

Dr Pat Tookey, Institute of Child Health, London

09301000

Antiretroviral therapy in pregnancy

What, why and when?
Dr Annemiek de Ruiter, St Thomas Hospital, London

10001025

Vaginal delivery and viral load

At what viral load (VL) is spontaneous vaginal delivery (SVD) safe?
Should women with an undetectable VL be treated as if they were HIV-negative?
Miss Kate Harding, St Thomas Hospital, London

10251045

Panel discussion

10451115

Morning coffee

Session Two Chair: Professor James Walker, University of Leeds

11151140

Does antiretroviral therapy cause pre-term delivery (PTD)?

Dr Claire Thorne, MRC Centre of Epidemiology for Child Health, London

11401200

Screening and testing for trisomy 21

How to manage an HIV-positive woman requiring invasive prenatal tests and how to
interpret results
Miss Sam Pretlove, Birmingham Womens Hospital

12001215

Panel discussion

Session Three Chair: Professor Jane Anderson, Homerton University Hospital, London
12151245

Peer support and the African experience

Dr Mitch Besser, mothers2mothers, Cape Town, South Africa

12451300

Peer support for pregnant women with HIV in the UK

Ms Angelina Namiba, HIV i-Base

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

RCOG/BHIVA Multidisciplinary Conference: HIV in Pregnancy

Friday 20 January 2012

PROGRAMME
13001400

Lunch

Session Four Chair: Mr Ed Dorman, Homerton University Hospital, London

14001420

Long-term effects of in utero and neonatal antiretroviral drug exposure on exposed but
uninfected infants
Dr Steve Welch, Birmingham Heartlands Hospital

14201450

HIV and breastfeeding: WHO and UK guidelines

Dr Graham Taylor, Imperial College London

14501510

Panel discussion to include Ms Alison Perry, St Jamess University Hospital, Leeds

Session Five Chair: Professor Catherine Nelson-Piercy, Guys and St Thomas

NHS Foundation Trust, London

15101540

Co-infection with hepatitis B or C

Mother-to-child transmission (MTCT), choice of ART and mode of delivery
Dr Ed Wilkins, North Manchester General Hospital

15401610

Management of term and pre-term rupture of membranes (ROM) in HIV

Dr Yvonne Gilleece, Royal Sussex County Hospital, Brighton
Dr Kees Boer, Consultant Obstetrician, Academic Medical Center, Amsterdam, The Netherlands

16101630

Panel discussion

1630

Summary and Close

Professor Jane Anderson, Chair, British HIV Association (BHIVA)
Professor James Walker, Senior Vice-president, Royal College of Obstetricians and Gynaecologists (RCOG)

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

RCOG/BHIVA Multidisciplinary Conference: HIV in Pregnancy

Friday 20 January 2012

BIOGRAPHIES
Jane Anderson (Homerton University Hospital NHS Foundation Trust and Barts and the London School of Medicine and
Dentistry) Working in East London, Professor Andersons clinical practice and research interest focus on HIV in ethnic
minority and migrant populations in the UK, with a special interest in the care of women with HIV. She has been elected
Chair of the British HIV Association (20112014) and is currently a member of the BHIVA Guidelines and Conference
subcommittees.

Mitchell Besser is an OBGYN whose career has been dedicated to the public health needs of women. He has been involved
in HIV/PMTCT care since 1991. In 2001, he founded mothers2mothers, providing education and psychosocial support to
pregnant women and new mothers living with HIV. Today, mothers2mothers reaches 20% of HIV-positive pregnant women
in the world.

Kees Boer worked until 2011 as obstetrician and associate professor in the Academic Medical Center, Amsterdam. He has
treated HIV-infected pregnant women since 1986. He has published on HIV but also on pre-eclampsia, prenatal diagnosis
and permanent effects of drugs on the offspring.

Peter Brocklehurst is Director of the Institute for Womens Health at University College London, and Co-Director of the
Policy Research Unit in Maternal Health and Care at the NPEU in Oxford, where he remains Professor of Perinatal
Epidemiology. Peter currently leads a large programme of clinical trials in perinatal care and, in relation to HIV infection,
he is co-author of three Cochrane reviews and has published in the area of condom availability and use in Kenya and post
partum morbidity in HIV-infected women in Uganda.

Annemiek de Ruiter is a Consultant Physician in HIV/GUM at St Thomas Hospital, London and has managed HIV-positive
patients for over 20 years, specialising in the management of pregnant women with HIV. Dr de Ruiter has published
extensively, formed local and national networks, collaborated widely, advised at a national level, lectured nationally and
internationally and led the development of the BHIVA 2008 and 2012 pregnancy guidelines and the 2010 infant feeding
guidelines.

Edgar Dorman is an obstetrician at Homerton University Hospital in East London. Ed has a special interest in high-risk
pregnancy and is the lead obstetrician for HIV. Prior to his current position, he worked for several years in East Africa where
he carried out research on malaria and HIV in pregnancy.

Yvonne Gilleece is a Consultant in HIV & Genitourinary Medicine at Brighton & Sussex University Hospitals NHS Trust
and an Honorary Senior Lecturer at Sussex University. Dr Gilleece is the Lead for HIV in Pregnancy and Hepatitis B as well
as a clinical supervisor for a PhD on HIV and Bone. She is a member of BASHH HIV SIG and has been an author on the BHIVA
guidelines for Hepatitis and for HIV-2.

Kate Harding has been a Consultant Obstetrician at Guys and St Thomas Hospital since 1997. Kate is Lead Obstetrician
for the Antenatal HIV service managing over 60 pregnant women annually. She has presented on HIV in pregnancy at
numerous venues including Primary care 2010, British Maternal Fetal Medicine Conference, Royal Society of Medicine and
Midwifery conferences. She is one of the two Obstetricians on the BHIVA HIV in Pregnancy 2011 writing committee and
has co-written a recent article on the international perspective of managing HIV in Pregnancy. Her other roles include
RCOG guidelines committee 20072010, International Society of Obstetric Medicine conference committee 2012 and
Preceptor for the Advanced Antenatal care ATSM.

Angelina Namiba has over 13 years experience of working in the HIV sector. As a woman living with HIV, Angelina is
passionate about advocating for the sexual health and reproductive rights of women living with HIV. From 20102011 she
led on the planning, development and delivery of the pilot project From Pregnancy to Baby and Beyond with Positively
UK. This developed a sustainable model of education, information, emotional and practical support for women living with
HIV through ante- to post-natal care. She is currently training as a Treatment Advocate for HIV i-base.

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

RCOG/BHIVA Multidisciplinary Conference: HIV in Pregnancy

Friday 20 January 2012

BIOGRAPHIES
Catherine Nelson-Piercy is a Consultant Obstetric Physician at Guys and St Thomas Hospitals Trust and Queen
Charlottes and Chelsea Hospital in London. She specialises in the care of women with medical problems in pregnancy.
Professor Nelson-Piercy runs special joint clinics for women with renal disease, cardiac and rheumatic disorders in pregnancy.
She has been involved in the development of several evidence-based National Guidelines notably for Contraception in
Women with Heart Disease, BTS /SIGN Asthma in Pregnancy and RCOG Green Top guideline on Reducing the risk of
thromboembolism during pregnancy, birth & the puerperium. Professor Nelson-Piercy is the President of the International
Society of Obstetric Medicine (ISOM).

Alison Perry has worked within the National Health Service since 1981; firstly completing her General Nurse Training and
then Midwifery. She has responsibility for all the screening programmes related to pregnancy but her special interest
remains with HIV and is responsible for around 60 women per year with HIV in pregnancy.

Sam Pretlove completed her subspecialty training in Maternal and Fetal medicine at Birmingham Womens Hospital in
2010 before taking up her consultant post there. Alongside the HIV physicians, specialist midwives and paediatricians she
manages the HIV work at BWH. The fetal medicine component of her job gives Dr Pretlove particular insight into the issues
surrounding screening and prenatal diagnosis in HIV-positive women.

Graham P Taylor is Reader in Communicable Diseases, Imperial College London and Honorary Consultant and Lead
Clinician, National Centre for Human Retrovirology, St Marys Hospital, London. Dr Taylor was Chief Medical Officer
(Medicine) for the Solomon Islands before joining St. Marys Hospital Medical School in 1992. His main interests lie in the
management of HIV infection during pregnancy, particularly the safety, efficacy and pharmacokinetics of antiretroviral
therapy. He has been a member of the BHIVA Guidelines Writing Committee on the Management of HIV infection in
Pregnancy since the first guidelines (1998).

Claire Thorne is a Wellcome Trust Research Career Development Fellow at University College Londons Institute of Child
Health, based in the Centre of Paediatric Epidemiology and Biostatistics. Dr Thorne is an infectious diseases epidemiologist
with a specific focus on HIV in pregnant and childbearing women and mother-to-child transmission. Claire has led the
scientific coordination of the European Collaborative Study (ECS), which involves a network of sites from 10 countries and
more than 10,000 mother-child pairs, since January 2006. Her research interests are the complex relationships between
pregnancy, HIV disease progression and antiretroviral therapy, mother-to-child transmission of HIV and its prevention,
adverse effects of antiretroviral drugs in pregnancy and childhood, the HIV epidemic in Eastern Europe and Central Asia
and HIV co-infections in pregnancy and childhood.

Pat Tookey Dr Tookey is a non-clinical epidemiologist with a long-standing research interest in screening and infections
affecting pregnant women and their children. She is responsible for the National Study of HIV in Pregnancy and Childhood
(NSHPC) and is a co-investigator on CHIPS, the collaborative follow-up study of HIV infected children.

James Walker is Professor, University Department of Obstetrics and Gynaecology, St Jamess University Hospital Trust,
Leeds, and Senior Vice President, RCOG. He has a special interest in high-risk obstetrics particularly pre-eclampsia. He is
Clinical Governance Lead to the senior Trust management. He is also leader of the Perinatal Research Group, Leeds Institute
of Molecular Medicine, Obstetric Advisor to the National Patient Safety Agency and Medical Director of Action on
Pre-eclampsia.

Steve Welch has been a consultant in paediatric HIV and infectious diseases at Heartlands Hospital, Birmingham since 2006.
He has helped establish adolescent transition services regionally, is one of the authors of the 2009 PENTA HIV treatment
guideline, and a member of CHIVAs guidelines group. Steve is a member of the PENTA Steering Committee, and is jointly
in charge of PENTAs training activities. He has been elected Chair of the Childrens HIV Association (20112014).

Ed Wilkins is Consultant in Infectious Diseases and Director of the HIV Research Unit at North Manchester General Hospital.
Dr Wilkins trained in infectious diseases in London and Liverpool, tropical medicine in Africa, and medical microbiology with
the Health Protection Agency, prior to taking up his current position in 1991. He has been involved with HIV patient care
and research since 1984, with interests in antiretroviral toxicity, hepatitis co-infection and the investigation of treatment
strategies, as well as being an active member of many executive and advisory national committees including BHIVA.

Conference Organiser: Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

Joint RCOG/BHIVA
Multidisciplinary Conference

HIV in Pregnancy
Friday 20 January 2012
Royal College of Obstetricians and Gynaecologists

Conference Organiser:
Mediscript Ltd 1 Mountview Court 310 Friern Barnet Lane London N20 0LD
T: 020 8369 5380 F: 020 8446 9194 E: conferences@mediscript.ltd.uk

Publication date: January 2012

London