First-trimester markers of aneuploidy in women positive for HIV.
OBJECTIVE
To investigate whether the sonographic and maternal serum biochemical markers used in first-trimester screening for chromosomal abnormalities are altered in pregnancies affected by maternal HIV infection.


METHODS
Nested case-control study.


METHODS
Routine antenatal visit in a teaching hospital.


METHODS
Ninety HIV-positive and 450 HIV-negative pregnant women.


METHODS
Findings from first-trimester antenatal visit for calculation of the risk for chromosomal abnormalities were compared between HIV-positive (treated and untreated) and HIV-negative women.


METHODS
First-trimester maternal serum free β human chorionic gonadotrophin (free β-hCG) pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal translucency thickness (NT), were compared.


RESULTS
There were no statistically significant differences between the HIV-positive and HIV-negative women in the median maternal levels of free β-hCG, PAPP-A and fetal NT. However, within the HIV-positive group those receiving antiretroviral treatment (n = 41) had a significantly lower median multiple of the median (MoM) for free β-hCG (0.74, interquartile range [IQR] 0.45-1.32 MoM) than HIV-positive women on no treatment (1.03, IQR 0.76-1.85 MoM; P = 0.006) and HIV-negative women (1.0, IQR 0.68-1.47 MoM; P = 0.003). There was no correlation between the level of free β-hCG or PAPP-A and maternal viral load or CD4(+) count.


CONCLUSIONS
Maternal levels of free β-hCG in treated HIV-positive pregnant women were lower compared with those in non-treated HIV-positive and HIV-negative women, whereas the PAPP-A levels and fetal NT remained unaltered.
Department of Maternal Fetal Medicine, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, UK. msavvidou@dsla.ndo.co.uk
M D
MD
Savvidou
I
I
Samuel
A
A
Syngelaki
M
M
Poulton
K H
KH
Nicolaides
D000328:Adult; D000782:Aneuploidy; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000188:drug therapy; D006784:Hospitals, Teaching; D006801:Humans; D048208:Nuchal Translucency Measurement; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging / Q000188:drug therapy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D012102:Reproductive Control Agents / Q000097:blood*; D012680:Sensitivity and Specificity; D014314:Trisomy / Q000175:diagnosis; D016216:Ultrasonography, Prenatal
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D012102:Reproductive Control Agents; D011266:Pregnancy-Associated Plasma Protein-A