Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series.
OBJECTIVE
To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures.


METHODS
Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used.


METHODS
University and hospital clinics.


METHODS
Pregnant women with HIV.


METHODS
Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated.


METHODS
Rate of invasive testing, intrauterine death, HIV transmission.


RESULTS
Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011-2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005.


CONCLUSIONS
The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment.


CONCLUSIONS
No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy.
M
M
Floridia
Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy.
G
G
Masuelli
Division of Gynaecology and Obstetrics, S. Giovanni di Dio Hospital, University of Cagliari, Cagliari, Italy.
A
A
Meloni
Department of Obstetrics and Gynaecology, Luigi Sacco Hospital, University of Milan, Milan, Italy.
I
I
Cetin
Department of Infectious Diseases, Catholic University, Rome, Italy.
E
E
Tamburrini
Department of Obstetrics & Gynaecology, Catholic University, Rome, Italy.
A F
AF
Cavaliere
Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
S
S
Dalzero
Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Naples, Italy.
M
M
Sansone
Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
S
S
Alberico
St. Orsola-Malpighi General Hospital, University of Bologna, Bologna, Italy.
B
B
Guerra
Department of Obstetrics and Gynaecology, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
A
A
Spinillo
Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy.
M
M
Chiadò Fiorio Tin
Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
M
M
Ravizza
D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D000704:Analysis of Variance; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D015193:Chorionic Villi Sampling / Q000009:adverse effects*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*
D044966:Anti-Retroviral Agents

HIV
; Amniocentesis; birth defects; chorionic villus sampling; invasive testing; mother-to child HIV transmission; pregnancy; prenatal diagnosis