Cohort profile: the Swiss Mother and Child HIV Cohort Study (MoCHiV)

TL;DR

The Swiss Mother and Child HIV Cohort Study (MoCHiV) tracks pregnant women with HIV and their children to prevent mother-to-child transmission and assess health outcomes.

Contribution

MoCHiV has influenced global practices in preventing HIV transmission and managing antiretroviral treatment effects in exposed and infected children.

Findings

The cohort includes 2154 children, with most being HIV-exposed but uninfected.

Research has impacted practices like elective caesarean sections and neonatal prophylaxis.

Future analyses will focus on other pathogens and social aspects like stigma.

Abstract

Prospective, multicentric observational cohort study in Switzerland investigating measures to prevent mother-to-child transmission in pregnant women with HIV (WWH) and assessing health and development of their exposed children as well as of children with HIV (CWH) in general.

Between January 1986 and December 2022, a total of 1446 mother–child pairs were enrolled. During the same period, the study also registered 187 CWH and 521 HIV-exposed but uninfected children (HEU), for whom detailed maternal information was not available. Consequently, the cohort comprises a total of 2154 children.

During these 37 years, research by the Swiss Mother and Child HIV Cohort Study (MoCHiV) and its international collaborators has strongly influenced the prevention of vertical transmission of HIV (eg, introduction and discontinuation of elective caesarean section, neonatal postexposure prophylaxis and breastfeeding). Contributions have also been made to the management of diagnostics (eg, p24 antigen assay) and the effects of antiretroviral treatment (eg, prematurity, growth) in HEU and CWH.

Most children present within the cohort are now HEU, highlighting the need to investigate other vertically transmitted pathogens such as hepatitis B and C viruses, cytomegalovirus or Treponema pallidum. In addition, analyses are planned on the longitudinal health status of CWH (eg, resistance and prolonged exposure to antiretroviral therapy), on social aspects including stigma in CWH and HEU, and on interventions to further optimise antenatal and postpartum care in WWH.

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