DOI: https://doi.org/10.36347/sasjm.2026.v12i10.020

Pages: 1131-1135

Background: Mother-to-child transmission (MTCT) is the principal route of pediatric HIV infection. In the absence of intervention, vertical transmission occurs in 15–45% of exposures, whereas a complete prevention-of-MTCT (PMTCT) cascade reduces this risk to below 5%. We describe the characteristics, PMTCT implementation and outcomes of HIV-exposed neonates managed over ten years at a Moroccan tertiary referral center. Methods: Retrospective single-center descriptive series of live neonates born to HIV-positive mothers and managed at the Neonatology and Neonatal Intensive Care Department of Hassan II University Hospital, Fez, between 2010 and 2019. The applied PMTCT protocol comprised maternal antiretroviral therapy (ART), caesarean delivery when indicated by a high third-trimester viral load, neonatal antiretroviral prophylaxis, exclusive replacement feeding, deferral of BCG, cotrimoxazole prophylaxis and a virological (PCR) follow-up schedule with confirmatory serology at 18 months. Infant HIV status was the main outcome. Descriptive statistics were used. Results: Thirty-two live neonates were included. Maternal infection had been diagnosed before pregnancy in 16 and during pregnancy in 16. Maternal ART had been started more than one month before delivery in 29 mothers, with adherence to caesarean indications; three mothers were diagnosed late, received no treatment and delivered vaginally. All neonates received antiretroviral prophylaxis and exclusive replacement feeding. HIV transmission occurred in 3 of 32 infants (9.4%); the remaining 29 were PCR-negative. The three transmissions corresponded to the three late-diagnosed, untreated mother–infant pairs, so that no transmission was observed among pairs that received the full antenatal PMTCT package. Conclusions: PMTCT was highly effective when the full cascade was delivered; residual transmission occurred exclusively in mother–infant pairs missed by antenatal screening. Strengthening universal antenatal and intra