Frequent detection of acute HIV infection in pregnant women.
Frequent detection of acute HIV infection in pregnant women.
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经常发现孕妇急性艾滋病毒感染。
DOI：
10.1097/qad.0b013e3282f155da
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Pilcher,ChristopherD
中科院分区：
文献类型：
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作者：
Patterson,KristineB;Leone,PeterA;Fiscus,SusanA;Kuruc,Joann;McCoy,SandraI;Wolf,Leslie;Foust,Evelyn;Williams,Del;Eron,JosephJ;Pilcher,ChristopherD
背景：通用产前HIV抗体检测，不检测急性HIV，是美国孕妇的标准。未确认的艾滋病毒收购在怀孕期间可能会导致围产期transmission.Objective：确定急性（抗体阴性）艾滋病毒感染的孕妇的患病率和评估的潜力，及时启动抗逆转录病毒治疗，以防止围产期transmission.Methods：从2002年11月1日至2005年4月30日，所有公共资助的艾滋病毒检测点参加了北卡罗来纳州的筛查和跟踪主动传播（STAT）计划，重新测试所有标本，是HIV抗体阴性的HIV RNA使用标本池。所有急性艾滋病毒感染者都立即被追踪，以进行评估、确证性检测、咨询和转诊服务。在这项研究中，所有感染急性艾滋病毒的孕妇立即开始接受抗逆转录病毒治疗，并前瞻性随访妊娠结果。结果：在研究期间，443名妇女的抗体检测呈艾滋病毒阳性; 15名艾滋病毒抗体呈阴性，但RNA检测呈阳性，其中5名在检测时已怀孕。这些孕妇接受了抗逆转录病毒药物治疗，并产下了未感染艾滋病毒的婴儿。产妇检测记录的所有六个艾滋病毒感染的婴儿出生在北卡罗来纳州显示三个母亲慢性艾滋病毒感染和三个艾滋病毒抗体阴性的私人产前testingfacility.Conclusions：在资源丰富的环境中，很大一部分的剩余围产期传播可能是从艾滋病毒收购在怀孕期间。标准的抗体测试错过了急性HIV感染，因此包括汇集HIV RNA测试的算法可能会改善其检测，并代表预防围产期传播的进一步机会。
Background:Universal prenatal HIV antibody testing, which does not detect acute HIV, is standard for pregnant women in the United States. Unrecognized HIV acquisition during pregnancy may result in higher rates of perinatal transmission.Objective:To determine the prevalence of acute (antibody-negative) HIV infection in pregnant women and to assess the potential for prompt initiation of antiretroviral therapy to prevent perinatal transmission.Methods:From 1 November 2002 to 30 April 2005, all publicly funded HIV testing sites participated in North Carolina's Screening and Tracing Active Transmission (STAT) Program, which retested all specimens that were HIV antibody negative for HIV RNA using specimen pooling. All patients with acute HIV infection were immediately traced for evaluation, confirmatory testing, counseling, and referral services. For this study, all pregnant women with acute HIV were immediately initiated onto antiretroviral therapy and followed prospectively for pregnancy outcomes.Results:During the study period, 443 women were HIV positive by antibody testing; 15 were HIV antibody negative but positive by RNA assay and of these five were pregnant at the time of testing. The pregnant women received antiretroviral drugs and delivered HIV-uninfected infants. Maternal testing records of all six HIV-infected infants born in North Carolina showed three mothers with chronic HIV infection and three HIV antibody negative at private prenatal testing facilities.Conclusions:In resource-rich settings, a substantial proportion of residual perinatal transmission may be from HIV acquisition during pregnancy. Standard antibody tests miss acute HIV infection and so algorithms that include pooled HIV RNA testing may improve its detection and represent a further opportunity to prevent perinatal transmission.