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


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.


CONCLUSIONS
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.
Brossard
Philippe
P
Department of Gynaecology and Obstetrics, University of Geneva Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. philippebrossard@bluewin.ch
Boulvain
Michel
M
Coll
Oriol
O
Barlow
Patricia
P
Aebi-Popp
Karoline
K
Bischof
Paul
P
Martinez de Tejada
Begoña
B
D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004314:Down Syndrome / Q000175:diagnosis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D015658:HIV Infections / Q000097:blood*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009436:Neural Tube Defects / Q000175:diagnosis; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D011296:Prenatal Diagnosis / Q000379:methods*; D000509:alpha-Fetoproteins / Q000032:analysis
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; D011266:Pregnancy-Associated Plasma Protein-A