Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy.
Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy.
BJOG. 2017 Jul;124(8):1218-1223. doi: 10.1111/1471-0528.14183. Epub 2016 Jun 20.
To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures.
Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used.
University and hospital clinics.
Pregnant women with HIV.
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.
Rate of invasive testing, intrauterine death, HIV transmission.
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.
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.
No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.
评估 HIV 感染孕妇行羊膜腔穿刺术和绒毛膜活检术（CVS）的比例，以及这些操作相关的结局。
观察性研究。使用意大利抗逆转录病毒治疗妊娠监测国家项目的数据。
大学和医院诊所。
HIV 感染孕妇。
采用方差分析和趋势 χ²检验分析时间趋势。通过学生 t 检验比较定量变量，通过 χ²检验比较分类数据，并计算比值比和 95%置信区间。
侵袭性检测率、宫内死亡、HIV 传播率。
2001 年至 2015 年间，在 2065 例 HIV 感染孕妇的妊娠中，有 113 例（5.5%）进行了侵袭性检测。99 例（87.6%）在接受抗逆转录病毒治疗时进行了这些检查，随着时间的推移，在高效抗逆转录病毒治疗（HAART）下进行的检查比例显著增加（2011-2015 年为 100%）。观察到 3 例宫内死亡（2.6%），14 例妊娠因胎儿畸形而终止。96 例活产新生儿中，有 8 例无 HIV 状态信息。在其余 88 例有羊膜腔穿刺术（n=75）、绒毛膜活检术（n=12）或两者均有的病例中，有 2 例发生 HIV 传播（2.3%）。在接受侵袭性检测时接受 HAART 的女性中未发生 HIV 传播，2005 年后也未发生。
这些发现进一步证实，在接受抑制性抗逆转录病毒治疗的孕妇中，侵袭性产前检测不会增加 HIV 垂直传播的风险。
在接受有效抗 HIV 治疗方案的女性中，行羊膜腔穿刺术或 CVS 未发生 HIV 传播。
