PERINATAL TRANSMISSION OF THE HUMAN-IMMUN ODEFICIENCY-VIRUS IN THE 2ND TRIMESTER OF PREGNANCY

BACKGROUND: A prospective study was carried out in pregnant women sero positive tor HIV-1 who wished to interrupt the pregnancy with the aim of detecting the specific sequences of DNA in fetal blood obtained by cordocentesis during the second trimester of pregnancy. METHODS: The s amples of fetal blood were obtained by cordocentesis with the Kleihaue r's test being performed to discard contamination of maternal blood. I n both maternal and fetal blood the HIV-1 antibodies, Western blot, p- 24 antigen and hematologic parameters were determined. The DNA-HIV-1 s equences were determined by double PCR. Fifteen pregnant women were in cluded in the study with one patient being excluded upon detection of contamination of fetal blood with maternal blood. In 8 cases the study could not be completed due to lack of material. RESULTS: The specific sequences of DNA of HIV were detected in the six pregnant women and i n three of the six fetuses studied. The anti-HIV-1 antibodies were pre sent in all the samples of maternal and fetal blood with the bands of antibodies by Western blot being identical for each mother-fetus pair. No differences were observed in the mother-fetus pair. No differences were observed in the hematologic parameters or in the lymphocytic sub populations among the fetuses with positive DNA sequences and those wh ich demonstrated a negative result.CONCLUSIONS: These preliminary resu lts suggest that fetal infection by HIV-1 may be produced during pregn ancy. Cordocentesis may be useful for determining the fetus which are infected in utero although this must be restricted to patients who wis h to terminate the pregnancy due to the potential risk of infecting a previously healthy fetus.