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Is screening for fetal anomalies reliable in HIV-infected pregnant women? A multicentre study

Coll, Oriol
Barlow, Patricia
Aebi-Popp, Karoline
Martinez de Tejada, Begoña
Published in AIDS. 2008, vol. 22, no. 15, p. 2013-7
Abstract OBJECTIVE: To assess the impact of HIV infection on the reliability of the first-trimester screening for Down syndrome, using free beta-human chorionic gonadotrophin, pregnancy-associated plasma protein-A and fetal nuchal translucency, and of the second-trimester screening for neural tube defects, using alpha-fetoprotein. PATIENTS AND METHODS: Multicentre study comparing the multiples of the median of markers for Down syndrome and neural tube defect screening among 214 HIV-infected pregnant women and 856 HIV-negative controls undergoing a first-trimester Down syndrome screening test, and 209 HIV-positive women and 836 HIV-negative controls with a risk evaluation for neural tube defect. The influence of treatment, chronic hepatitis and HIV disease characteristics were also evaluated. RESULTS: Multiples of the median medians for pregnancy-associated plasma protein-A and beta-human chorionic gonadotrophin were lower in HIV-positive women than controls (0.88 vs. 1.05 and 0.84 vs. 1.09, respectively; P < 0.005), but these differences had no impact on risk estimation; no differences were observed for the other markers. No association was found between HIV disease characteristics, antiretroviral treatment use at the time of screening or chronic hepatitis and marker levels. CONCLUSION: Screening for Down syndrome during the first trimester and for neural tube defect during the second trimester is accurate for HIV-infected women and should be offered, similar to HIV-negative women.
Keywords AdultBiological Markers/bloodChorionic Gonadotropin, beta Subunit, Human/bloodDown Syndrome/diagnosisFemaleFetal Diseases/diagnosisHIV Infections/bloodHumansMass Screening/methodsNeural Tube Defects/diagnosisNuchal Translucency MeasurementPregnancyPregnancy Complications, Infectious/bloodPregnancy-Associated Plasma Protein-A/analysisPrenatal Diagnosis/methodsAlpha-Fetoproteins/analysis
Stable URL https://archive-ouverte.unige.ch/unige:1321
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PMID: 18784463
Research groups Swiss HIV Cohort Study
Swiss Mother and Child HIV Cohort Study

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Deposited on : 2009-04-02

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