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The impact of HIV infection and antiretroviral therapy on the predicted risk of Down syndrome
Author(s) -
Charlton Thomas G.,
Franklin Jamie M.,
Douglas Melanie,
Short Charlotte E.,
Mills Ian,
Smith Rachel,
Clarke Amanda,
Smith John,
Tookey Pat A.,
CortinaBorja Mario,
Taylor Graham P.
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4267
Subject(s) - serostatus , medicine , down syndrome , population , incidence (geometry) , immunology , obstetrics , human immunodeficiency virus (hiv) , viral load , physics , environmental health , psychiatry , optics
Objective The aim of this study was to assess predicted Down syndrome risk, based on three serum analytes (triple test), with HIV infection status and antiretroviral therapy regimen. Methods Screening results in 72 HIV‐positive women were compared with results from age‐matched and race‐matched HIV‐negative controls. Mean concentrations of each analyte were compared by serostatus and antiretroviral therapy. Observed Down syndrome incidence in the offspring of HIV‐positive women was calculated from national HIV surveillance data. Results Overall, women with HIV had a significantly higher probability of receiving a ‘high‐risk’ result than uninfected controls ( p = 0.002). Compared with matched uninfected controls, women with HIV infection had significantly higher human chorionic gonadotrophin, lower unconjugated estriol, and higher overall predicted risk of their infant having Down syndrome (1/6250 vs. 1/50 000 p = < 0.001). National surveillance data show no evidence of higher than expected incidence of Down syndrome in the offspring of HIV‐positive women. Conclusions HIV infection impacts the serum analytes used to assay for Down syndrome risk resulting in a high rate of ‘high risk’ results. However, there is no population‐based association between maternal HIV infection and Down syndrome. Care should be taken when interpreting high‐risk serum screening results in HIV‐positive women to avoid unnecessary invasive diagnostic procedures. © 2013 John Wiley & Sons, Ltd.