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Case Reports
. 2013 Fall;24(3):e91-5.
doi: 10.1155/2013/185192.

Amniocentesis in the HIV-infected pregnant woman: Is there still cause for concern in the era of combination antiretroviral therapy?

Nisha Andany  1 , Michelle Letchumanan  2 , Lise Bondy  1 , Kellie Murphy  3 , Mona R Loutfy  4
Affiliations
Case Reports

Amniocentesis in the HIV-infected pregnant woman: Is there still cause for concern in the era of combination antiretroviral therapy?

Nisha Andany et al. Can J Infect Dis Med Microbiol. 2013 Fall.

Abstract
in English, French

The current standard of care in Canadian obstetrical practice is to offer pregnant women the opportunity for prenatal investigation to diagnose congenital abnormalities. Prenatal amniocentesis is Canada's most commonly practiced invasive procedure for the diagnosis of chromosomal and single gene disorders. The potential risk of intrapartum HIV transmission during amniocentesis raises several ethical concerns and limits the availability of prenatal genetic testing for HIV-positive pregnant women. Complete virological suppression with antiretroviral therapy may alleviate the risk of mother-to-child transmission during amniocentesis and increase accessibility of this important diagnostic tool in the HIV-positive population. The present report describes a case involving a 32-year-old HIV-positive pregnant woman whose plasma viral load was undetectable on antiretroviral therapy; she underwent successful prenatal amniocentesis without transmission of HIV to her infant.

La norme actuelle des soins dans la pratique obstétricale canadienne consiste à offrir aux femmes enceintes la possibilité d’une évaluation prénatale afin de diagnostiquer des anomalies congénitales. L’amniocentèse prénatale est l’intervention invasive la plus pratiquée au Canada pour diagnostiquer des troubles chromosomiques ou monogéniques. Le risque potentiel de transmission intrapartum du VIH pendant l’amniocentèse soulève plusieurs questions éthiques et limite la disponibilité des tests génétiques prénatals chez les femmes enceintes positives au VIH. La suppression virologique totale grâce à l’antirétrovirothérapie pourrait réduire le risque de transmission entre la mère et l’enfant pendant l’amniocentèse et accroître l’accessibilité à cet important outil diagnostique au sein de la population positive au VIH. Le présent rapport décrit le cas d’une femme enceinte de 32 ans positive au VIH sous antivirothérapie et dont la charge virale plasmatique n’était pas décelable. Elle a subi une amniocentèse prénatale sans transmettre le VIH à son nourrisson.

Keywords: Amniocentesis; Antiretroviral therapy; HIV; Undetectable viral load.

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