title: Amniocentesis in pregnant HIV-infected patients. Absence of mother-to-child viral transmission in a series of selected patients.
abstract: OBJECTIVE
  To assess the risk of vertical transmission in HIV-infected pregnant women undergoing diagnostic amniocentesis, and to identify possible predictive factors.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of obstetrics and gynecology, Hôpital Delafontaine, 2 rue du docteur Pierre-Delafontaine, 93205 Saint-Denis, France.
authors.forename: Dieudonné
authors.initials: D
authors.lastname: Ekoukou
authors.forename: Marie-Aude
authors.initials: MA
authors.lastname: Khuong-Josses
authors.forename: Nelly
authors.initials: N
authors.lastname: Ghibaudo
authors.forename: Denis
authors.initials: D
authors.lastname: Mechali
authors.forename: Daniel
authors.initials: D
authors.lastname: Rotten
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000635:transmission*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D012189:Retrospective Studies; D019562:Viral Load; D055815:Young Adult