TESTING FOR IN-UTERO HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION WITH FETAL BLOOD-SAMPLING

OBJECTIVE: Our purpose was to evaluate the potential of midtrimester f etal blood sampling to detect in utero human immunodeficiency virus ty pe 1 infection. STUDY DESIGN: Ultrasonographically guided fetal blood sampling was performed before pregnancy termination in 28 women infect ed with human immunodeficiency virus type 1. Mean gestational age was 22 weeks (range 15 to 29 weeks). Samples were tested for human immunod eficiency virus with undissociated p24 antigen and deoxyribonucleic ac id polymerase chain reaction or viral isolation by cell culture. After terminations fetal thymuses were also tested for human immunodeficien cy virus infection by polymerase chain reaction. Polymerase chain reac tion was also performed on maternal cells to confirm that the primer p airs used were able to detect human immunodeficiency virus type 1 stra ins present. RESULTS: All fetal blood samples had negative results by p24 antigen and polymerase chain reaction or virus culture and all fet al thymuses were negative by polymerase chain reaction. CONCLUSION: Ea rly in utero human immunodeficiency virus infection appears infrequent , supporting the hypothesis that mother-to-child transmission predomin antly occurs late in pregnancy. Therefore midtrimester prenatal diagno sis is not currently of use to women in making reproductive decisions.