Rapid HIV Testing Late in Pregnancy Proves Helpful in Peruvian Expectant Mothers

By David Douglas

HIV-1 testing of women in late pregnancy by means of rapid serological assays has proved useful in establishing HIV status, according to US and Peruvian researchers.

As lead author Dr. Ann J. Melvin told Reuters Health, "use of rapid HIV-1 diagnosis at delivery is feasible and could be an effective component of a strategy to decrease the rate of mother-to-child HIV-1 transmission in many communities."

In the October issue of AIDS Research and Human Retroviruses, Dr. Melvin of the University of Washington, Seattle, and colleagues note that they offered such rapid testing to pregnant women who presented at the emergency department of a large maternity hospital in Lima.

The tests used were the OraQuick HIV 1/2 (Orasure) and the Determine HIV 1/2 (Abbott Diagnostics). Staff experienced few problems conducting the tests and the recipients showed no preference for oral fluid or blood sampling approaches.

Over a period of about 10 months, 3543 women were tested and 27 were positive by one or both assays. Two of the women proved negative after standard testing and such results were not available for another three.

Those who tested positive were offered standard HIV obstetrical care including the use of antiretrovirals. In all, 17 of 19 women for whom information was available received antiretroviral therapy before delivery. Of women who received nevirapine, 80% did so at least 1 hour before delivery.

The team concludes that HIV testing is feasible and acceptable in late pregnancy or at delivery. However, Dr. Melvin said, "because of the limitations of this approach, greater emphasis should be placed on the development of prenatal HIV-1 testing and treatment programs."

11/22/04

AIDS Res Hum Retroviruses 2004;20:1046-1052.