Does Amniocentesis or CVS Increase the risk of HIV Vertical Transmission?
BACKGROUND AND PURPOSE:
Recent studies indicate minimal to no additional risk of HIV transmission if prenatal diagnostic testing is performed under treatment with effective combination regimens (highly active antiretroviral therapy, HAART)
Studies have small sample sizes
Floridia et al. (BJOG, 2017) sought to confirm these findings by analyzing larger cohorts of pregnant women with HIV to determine the relationship between invasive procedures and outcomes
National observational study of 2065 pregnant women with HIV
National Program on Surveillance on Antiretroviral Treatment in Pregnancy in Italy
Main outcomes were rate of invasive testing, intrauterine death, HIV transmission
5.5% of subjects had invasive tests performed
87.6% of procedures were conducted under antiretroviral treatment, with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) reaching 100% from 2011-2015
Among 88 live births with either amniocentesis, CVS, or both, two HIV transmissions occurred
No transmission cases after 2005
One of the cases was a primary infection with HIV
No HIV transmission occurred among the women who were on HAART at the time of invasive testing
Invasive prenatal testing does not appear to increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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