Investigation of HIV in amniotic fluid from HIV-infected pregnant women at full term.

ABSTRACT

BACKGROUND: In the absence of interventions and breast-feeding, the in utero transmission rate of human immunodeficiency virus (HIV) is estimated to be 10%-15%, and the role that amniotic fluid (AF) plays in this is unclear. OBJECTIVES: Levels of cytomegalovirus (CMV) in AF and levels of HIV-1 in AF, maternal blood, and fetal cord blood were assessed.Study design. We enrolled 23 HIV-1-positive women with healthy, singleton pregnancies who underwent elective cesarean section (CS) at full term. The Roche Amplicor HIV-1 Monitor test (version 1.5) was used for determination of maternal plasma VLs. The NASBA Nuclisens assay was used for determination of VLs in other samples. To determine the feasibility of detecting viral infections in AF, CMV polymerase chain reaction DNA extraction was performed on the AF samples by use of the QIAamp DNA kit. RESULTS: HIV-1 RNA was not detected in either AF or fetal cord blood. CMV was detected in 4 AF samples. Maternal CD4(+) T cell counts were 158-654 cells/mL (mean, 405 cells/mL). The maternal plasma VLs ranged from below detectable limits to 169,990 copies/mL (mean, 33,700 copies/mL). CONCLUSIONS: In the absence of medical complications and before labor, AF collected during elective CS from women who had received either zidovudine or nevirapine during late-stage pregnancy was free of HIV.