Investigation of HIV in amniotic fluid from HIV-infected pregnant women at full term.
BACKGROUND
In the absence of interventions and breast-feeding, the in utero transmission rate of human immunodeficiency virus (HIV) is estimated to be 10%-15%, and the role that amniotic fluid (AF) plays in this is unclear.


OBJECTIVE
Levels of cytomegalovirus (CMV) in AF and levels of HIV-1 in AF, maternal blood, and fetal cord blood were assessed.Study design. We enrolled 23 HIV-1-positive women with healthy, singleton pregnancies who underwent elective cesarean section (CS) at full term. The Roche Amplicor HIV-1 Monitor test (version 1.5) was used for determination of maternal plasma VLs. The NASBA Nuclisens assay was used for determination of VLs in other samples. To determine the feasibility of detecting viral infections in AF, CMV polymerase chain reaction DNA extraction was performed on the AF samples by use of the QIAamp DNA kit.


RESULTS
HIV-1 RNA was not detected in either AF or fetal cord blood. CMV was detected in 4 AF samples. Maternal CD4(+) T cell counts were 158-654 cells/mL (mean, 405 cells/mL). The maternal plasma VLs ranged from below detectable limits to 169,990 copies/mL (mean, 33,700 copies/mL).


CONCLUSIONS
In the absence of medical complications and before labor, AF collected during elective CS from women who had received either zidovudine or nevirapine during late-stage pregnancy was free of HIV.
Department of Obstetrics and Gynaecology, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa.
Boshishi K F
BK
Mohlala
Timothy J
TJ
Tucker
Mitchell J
MJ
Besser
Carolyn
C
Williamson
Jane
J
Yeats
Lynette
L
Smit
John
J
Anthony
Adrian
A
Puren
D000293:Adolescent; D000328:Adult; D000653:Amniotic Fluid / Q000821:virology*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000302:isolation & purification; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000821:virology*; D011263:Pregnancy Trimester, Third; D019562:Viral Load
D019380:Anti-HIV Agents