The UK CHIC Study provides important information on the status of individuals infected with HIV in the UK, and provides a means to study the response to HAART and to monitor changes in the clinical event and death rates that have occurred since the introduction of HAART in the UK.

Objective: To describe the epidemiology of HIV-1 infection in pregnant women in the United Kingdom. Design: Serial unlinked serosurveillance for HIV-1 in neonatal specimens and surveillance through registers of diagnosed maternal and paediatric infections from reporting by obstetricians, paediatricians, and microbiologists.

Infections acquired in Africa and among Africans are making an increasing contribution to HIV infection in the United Kingdom. Migration, diagnosis of long-standing infection and incident cases are all potential influences, but they are difficult to measure. Improvement in early diagnosis of HIV continues to be an important component of intervention to prevent onward vertical and sexual transmission and to promote access to treatment and care.

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weeks' gestation had raised death rates from noncardiovascular causes, reflected in higher rates from all causes combined. This was unexpected and requires confirmation by continued follow up and other studies now in progress. The babies born after term had larger head size, which was also associated with higher rates of disease other than cardiovascular disease.In conclusion, this study shows for the first time that reduced fetal growth is followed by higher death rates from cardiovascular disease in adult life. Bodily proportions at birth suggest that the growth reduction began early in gestation. We suggest that this is further evidence that cardiovascular disease originates through programming in fetal life and infancy. Matemal nutrition may be an important influence on programming.We are grateful to Mr D R Millar, consultant obstetrician; Mrs Bullas and the staff of the medical records department at the Jessop Hospital for Women who preserved the records and allowed us to use them; and to the staff at NHS central registry and OPCS who traced the men. The study was supported by a grant from the Wellcome Trust.