Amniocentesis in pregnant HIV-infected patients Absence of mother-to-child viral transmission in a series of selected patients
ABSTRACT To assess the risk of vertical transmission in HIV-infected pregnant women undergoing diagnostic amniocentesis, and to identify possible predictive factors.
This was a single center retrospective study. The records of 330 HIV-infected pregnant women booked in our antenatal clinic from 31 January 2001 to 31 January 2006 were analyzed. Women who actually underwent diagnostic amniocentesis ("amniocentesis performed" group) were compared to those eligible for amniocentesis but who did not undergo the procedure ("amniocentesis withheld" group).
During the time period, 318 liveborn babies were delivered (9 HIV infected (2.8%)). Thirty-four women (35 fetuses) were eligible for diagnostic amniocentesis. Amniocentesis was performed in 11 (32.4%) of these women (12 fetuses, none infected among the 9 liveborns) and withheld in 23 (67.6%) women. Among the 19 liveborn babies in this latter group, 1 (5.3%) was infected. There was no statistical difference in vertical transmission rate between the whole cohort of HIV-infected pregnant women and the group of women eligible for amniocentesis; or between the women who actually had or did not have an amniocentesis. The women who did undergo amniocentesis all received highly active antiretroviral combination therapy with three drugs; all but two had an undetectable HIV viral load, only one had immunosuppression and none had HCV co-infection.
No vertical transmission was observed in a group of nine liveborn babies after amniocentesis performed in selected HIV-infected pregnant women. In the presence of high genetic risk during pregnancy, amniocentesis can be considered after proper patient counselling.
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ABSTRACT: Very few studies have properly addressed to the risk of fetal hepatitis B (HBV), hepatitis C (HCV) or human immunodeficiency virus (HIV) infection through amniocentesis. For HBV, this risk is low. However, knowledge of the maternal hepatitis B e antigen status is valuable in the counselling of risks associated with amniocentesis. For HCV, the risk is not well known but cannot be excluded. For HIV, it seems rational to propose a viral test before amniocentesis for patients with contamination's risk and to postpone the sampling in cases with positive results in order to obtain an undetectable HIV-1 RNA viral load. For these reasons, it can be useful to analyse for each virus the benefit of amniocentesis and the risk of mother-to-infant transmission, and to inform the patient.Journal de Gynécologie Obstétrique et Biologie de la Reproduction 09/2009; 38(6):469-73. DOI:10.1016/j.jgyn.2009.07.001 · 0.62 Impact Factor
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ABSTRACT: The risk of transmission of human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C virus (HCV) during invasive procedures may not be negligible, although it has been poorly assessed. The risk of hepatitis B transmission during amniocentesis seems to be low, but it may be increased in women with a positive HBeAg. HCV transmission risk cannot be established because evidence is lacking. No information exists about other invasive procedures in such infections. An increased risk of vertical transmission following an invasive procedure was suggested in HIV infection, but amniocentesis seems to be safe when performed under highly active antiretroviral treatment, with a low viral load and when avoiding placental passage. International guidelines do not clearly define policies to screen for maternal blood-borne virus infection during invasive procedures. Nevertheless, serological status should be assessed in all cases and parents should be aware of the existing evidence for transmission risk. Transplacental amniocentesis should always be avoided.Fetal Diagnosis and Therapy 01/2010; 28(1):1-8. DOI:10.1159/000309155 · 2.30 Impact Factor
- Recent Translational Research in HIV/AIDS, 11/2011; , ISBN: 978-953-307-719-2